Acute otitis media and sociomedical risk factors among unselected childrenin Greenland

Objective: To describe the sociomedical risk factors associated with episod es of acute otitis media (AOM), recurrent AOM (rAOM), and chronic otitis me dia (COM) in Greenlandic children and especially to point out children at h igh risk of rAOM (defined as greater than or equal to 5 AOM episodes since birth) and COM which are prevalent among Inuit children all over the Arctic . Methods: The study design was cross-sectional and included 740 unselected children, 3, 4, 5, and 8-years-old, living in two major Greenlandic towns, Nuuk and Sisimiut. All children were otologically examined and the parents answered a questionnaire containing sociomedical variables including ethni city, family history of OM, housing, insulation, crowding, daycare, passive cigarette smoking, breast feeding, type of diet, allergy, and chronic dise ases. Historical data were cross-checked in medical records which also form ed the basis for the drop-out analyses. Statistical analyses included frequ ency tests, calculation of odds ratio (OR), and multiple logistic regressio n. Results: The attendance rate was 86%. Former episode of AOM was reported by 2/3 of the children, rAOM by 20%, and COM by 9%. The following variable s were found significantly more often in children with AOM by simple freque ncy testing: Parental (OR = 1.83), sibling (OR = 1.62), and parental plus s ibling (OR = 2.56) history of OM, crowding (OR = 5.55), long period of excl usive breast feeding (> 4 months) (OR = 2.47), and recent acute disease (P = 0.034). The following variables were found significantly more often in ch ildren with rAOM or COM by simple frequency testing: Parental history of OM (OR = 1.60; OR = 2.11, respectively) and no recall of breast feeding (P = 0.005; P = 0.003, respectively). Also, COM was found significantly more oft en in children with two Greenlandic parents (OR = 3.07). A multiple logisti c regression test denoted only parental history of OM (OR = 1.82) and long period of exclusive breast feeding (OR = 1.14) as significant predictors of AOM. Conclusions: Many of the risk factors usually associated with AOM cou ld not be confirmed as risk factors in this survey. Parental history of OM and long period of exclusive breast feeding were the strongest factors asso ciated with AOM in Greenlandic children and ethnicity was associated with C OM. However, the study confirms that AOM is a multifactorial disease determ ined by a number of genetic and environmental factors. (C) 1999 Elsevier Sc ience Ireland Ltd. All rights reserved.