The association between iron-deficiency anemia and recurrent acute otitis media

Purpose: This study was designed to examine the association between iron-de ficiency anemia and the frequency of recurrent acute otitis media in childr en, and to evaluate the effect of restoring normal hemoglobin levels on the frequency of acute otitis media attacks. Materials and Methods: A total of 680 children with frequent episodes of ac ute otitis media were enrolled in the study. The levels of the hemoglobin w ere measured in both these children and in 200 healthy children with no his tory of infections. The correlation between hemoglobin level and the freque ncy of middle ear infections was studied and analyzed. All children with he moglobin levels lower than 9.5 g/dL received iron supplementation until the y reached a level of at least 11 g/dL, and the subsequent frequency of midd le ear infections was recorded. Results: The 680 children had an average of 8.3 +/- 2.7 episodes of acute o titis media per year per child, and an average hemoglobin level of 11.4 +/- 2.7 g/dL, whereas the controls had an average hemoglobin level of 13.1 +/- 2.5 g/dL. Twenty percent had hemoglobin levels below 9.5 g/dL. These child ren had more episodes of acute otitis media when compared with children wit h average levels. By increasing the hemoglobin level in these children, the frequency of the episodes of acute otitis media decreased significantly. Conclusions: This study confirms that anemic children have higher prevalenc e of episodes of acute otitis media in comparison to healthy, nonanemic chi ldren, and shows that there is a direct relationship between the degree of the anemia and the number of the episodes. Copyright (C) 2001 by W.B. Saund ers Company.