title: Outpatient and hospital visits associated with otitis media among American Indian and Alaska native children younger than 5 years.
abstract: OBJECTIVE
  To describe the burden of otitis media (OM) among American Indian and Alaska Native (AI/AN) children.
  
  
  METHODS
  OM morbidity among AI/AN younger than 5 years was evaluated using OM-associated outpatient visit and hospitalization rates. These rates were compared with outpatient and hospitalization rates for the general US population of children younger than 5 years. AI/AN children who were younger than 5 years and receiving care through the Indian Health Service or tribally operated facilities and US children younger than 5 years of age were studied.
  
  
  RESULTS
  From 1994--1996, the average annual rate of AI/AN OM-associated outpatient visits was 138 per 100 children younger than 5 years. Among AI/AN children younger than 1 year (infants), these rates were almost 3 times greater than those for US infants (318 vs 110 visits per 100 infants, respectively). AI/AN children 1 to 4 years of age had rates 1.5 times greater than US children of the same age (107 vs 65 visits per 100 children, respectively). AI/AN children also experienced higher rates of OM-associated hospitalization than did US children (5643 vs 2440 per 100 000 infants, 823 vs 665 per 100 000 1- to 4-year-olds).
  
  
  CONCLUSIONS
  We found that AI/AN children, especially AI/AN infants, have higher OM-associated outpatient and hospitalization rates than those for the general US population of children. The disparity in rates suggests that additional prevention programs and continued resources are needed to reduce OM morbidity among AI/AN children.
authors.affiliation: Office of the Director, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, Georgia 30333, USA. acurns@cdc.gov
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Curns
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.forename: David K
authors.initials: DK
authors.lastname: Shay
authors.forename: James E
authors.initials: JE
authors.lastname: Cheek
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Kaufman
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Anderson
mesh_terms: D000413:Alaska / Q000453:epidemiology; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D004930:Inuit / Q000706:statistics & numerical data; D008297:Male; D010033:Otitis Media / Q000208:ethnology*; D014481:United States / Q000453:epidemiology