Risk factors for otitis media with effusion in Chinese schoolchildren: a nested case-control study and review of the literature.
OBJECTIVE
To identify the risk factors for otitis media with effusion (OME) in Chinese schoolchildren and analyse the results with reference to the review of the literature.


METHODS
The study subjects were 6-7-year-old children drawn from a school-screening program for OME in Hong Kong. Both positive and negative screens attended a hospital clinic for further assessment with repeated otoscopic examination and tympanometry as well as pure tone audiometry within 3 weeks after the initial school-screening. During the visit, parents were interviewed to provide information with regard to the children's birth history, neonatal history, socio-economic background, otological history, past health, and medical history. These data formed the basis in the estimation of potential risk factors for OME.


RESULTS
In the univariate analysis of 127 cases and 173 controls, significantly elevated odds ratios (OR) for OME were detected on the symptoms of atopy (OR = 2.21, p = 0.04), hearing loss (OR = 4.13, p = 0.001), nasal obstruction (OR = 1.94, p = 0.005), rhinorrhoea (OR = 1.61, p = 0.04), tonsillitis in the past 12 months (OR = 1.82, p = 0.02), and previous history of acute otitis media (OR = 6.89, p < 0.001). However, only three of them were found to be significant in the multivariate logistic regression model: nasal obstruction (OR = 1.67, 95% CI: 1.01-2.75); acute tonsillitis (OR = 1.68, 95% CI: 1.00-2.80), and previous acute otitis media episodes (OR = 5.75, 95% CI: 2.60-12.69).


CONCLUSIONS
Risk factors identified in the Chinese schoolchildren for OME were comparable with previous western reports. A previous attack of acute otitis media was a major determinant for middle ear effusion.
Tong
Michael C F
MC
Division of Otorhinolaryngology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, SAR, China. mtong@cuhk.edu.hk
Yue
Virgil
V
Ku
Peter K M
PK
Lo
Phoebe S Y
PS
Wong
Eric M C
EM
van Hasselt
C Andrew
CA
D016022:Case-Control Studies; D002648:Child; D005260:Female; D034381:Hearing Loss / Q000209:etiology; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015508:Nasal Obstruction / Q000150:complications; D016017:Odds Ratio; D010034:Otitis Media with Effusion / Q000453:epidemiology* / Q000209:etiology; D038781:Otoscopy; D012307:Risk Factors; D014069:Tonsillitis / Q000150:complications