Absent otoacoustic emissions predict otitis media in young Aboriginal children: a birth cohort study in Aboriginal and non-Aboriginal children in an arid zone of Western Australia
Creators: name: Lehmann, Deborah
name: Weeks, Sharon
name: Jacoby, Peter
name: Elsbury, Dimity
name: Finucane, Janine
name: Stokes, Annette
name: Monck, Ruth
name: Coates, Harvey
name: Aalberse, J.
name: Alpers, K.
name: Arumugaswamy, A.
name: Beissbarth, J.
name: Bonney, P.
name: Bowman, J.
name: Carter, J.
name: Carville, K.
name: Coleman, S.
name: Cripps, A.
name: Dorizzi, L.
name: Dunn, D.
name: Edwards, E.
name: Forrest, A.
name: Foxwell, R.
name: Gordon, C.
name: Harrington, B.
name: Harnett, G.
name: Jeffries-Stokes, C.
name: Johnston, J.
name: de Klerk, N. H.
name: Kyd, J.
name: Kyaw-Myint, S. M.
name: Lannigan, F.
name: Leach, A. J.
name: Lewis, T.
name: McAullay, D.
name: McIntosh, P.
name: Meiklejohn, K.
name: Murphy, D.
name: Nichols, F.
name: Pingault, N.
name: Richmond, P.
name: Riley, T. V.
name: Sivwright, K.
name: Smith, D.
name: Sorian, S.
name: Spencer, J.
name: Stanley, F. J.
name: Tamwoy, J.
name: Taylor, Adam
name: Watson, K.
name: Wood, Katie
name: Wood, K.
Publisher: name: Swinburne
Year: 2024

description: Otitis media (OM) is the most common paediatric illness for which antibiotics are prescribed. In Australian Aboriginal children OM is frequently asymptomatic and starts at a younger age, is more common and more likely to result in hearing loss than in non-Aboriginal children. Absent transient evoked otoacoustic emissions (TEOAEs) may predict subsequent risk of OM. 100 Aboriginal and 180 non-Aboriginal children in a semi-arid zone of Western Australia were followed regularly from birth to age 2 years. Tympanometry was conducted at routine field follow-up from age 3 months. Routine clinical examination by an ENT specialist was to be done 3 times and hearing assessment by an audiologist twice. TEOAEs were measured at ages &lt;1 and 1-2 months. Cox proportional hazards model was used to investigate the association between absent TEOAEs and subsequent risk of OM. At routine ENT specialist clinics, OM was detected in 55% of 184 examinations in Aboriginal children and 26% of 392 examinations in non-Aboriginal children; peak prevalence was 72% at age 5-9 months in Aboriginal children and 40% at 10-14 months in non-Aboriginal children. Moderate-severe hearing loss was present in 32% of 47 Aboriginal children and 7% of 120 non-Aboriginal children aged 12 months or more. TEOAE responses were present in 90% (46/51) of Aboriginal children and 99% (120/121) of non-Aboriginal children aged &lt;1 month and in 62% (21/ 34) and 93% (108/116), respectively, in Aboriginal and non-Aboriginal children at age 1-2 months. Aboriginal children who failed TEOAE at age 1-2 months were 2.6 times more likely to develop OM subsequently than those who passed. Overall prevalence of type B tympanograms at field follow-up was 50% (n = 78) in Aboriginal children and 20% (n = 95) in non-Aboriginal children. The burden of middle ear disease is high in all children, but particularly in Aboriginal children, one-third of whom suffer from moderate-severe hearing loss. In view of the frequently silent nature of OM, every opportunity must be taken to screen for OM. Measurement of TEOAEs at age 1-2 months to identify children at risk of developing OM should be evaluated in a routine health service setting.