title: Acute otitis media during the first two years of life in a rural community in Bangladesh: a prospective cohort study.
abstract: The study investigated the burden of acute otitis media (AOM) during the first two years of life in a cohort of 252 newborns in rural Bangladesh using data collected on occurrences of AOM. Trained community health workers (CHWs) conducted household surveillance and picked up cases of AOM using the study algorithm. The incidence rate was 0.9 episodes per child-year observed. Forty-six percent (n=115) of the 252 subjects developed AOM: 36% (n=91) during the first year of life and 10% (n=24) during the second year of life (p<0.001). The age-specific incidence rates of AOM varied; peaks occurred in the 6-12-month age-group and the lowest in the first three months of life. In total, 20% (n=49) of the study subjects had single, 26% (n=66) recurrent, and 54% (n=137) no episode of AOM. Perforation with discharge developed in 85% (n=322) of 375 episodes. The duration of discharge from the ears was < or =6 weeks in 95% of the episodes, but in 5% of the episodes, discharge from the ears continued for >6 weeks. The incidence of AOM was higher in the monsoon season compared to the summer season (p<0.003). The study documented AOM as an important cause of morbidity among rural children up to two years of age in Bangladesh and should be addressed with strategies to overcome the burden of disease.
authors.affiliation: Child Health Unit, Public Health Sciences Division, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. eliza@icddrb.org
authors.forename: Eliza
authors.initials: E
authors.lastname: Roy
authors.forename: Kh Zahid
authors.initials: KhZ
authors.lastname: Hasan
authors.forename: Fazlul
authors.initials: F
authors.lastname: Haque
authors.forename: A K M
authors.initials: AK
authors.lastname: Siddique
authors.forename: Richard Bradley
authors.initials: RB
authors.lastname: Sack
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D001459:Bangladesh / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000453:epidemiology*; D011446:Prospective Studies; D012423:Rural Health; D012621:Seasons; D018571:Sentinel Surveillance