title: Impact of swimming on chronic suppurative otitis media in Aboriginal children: a randomised controlled trial.
abstract: OBJECTIVE
  To measure the impact of 4 weeks of daily swimming on rates of ear discharge among Aboriginal children with a tympanic membrane perforation (TMP) and on the microbiology of the nasopharynx and middle ear.
  
  
  METHODS
  A randomised controlled trial involving 89 Aboriginal children (aged 5-12 2013s) with a TMP, conducted in two remote Northern Territory Aboriginal communities from August to December 2009.
  
  
  METHODS
  4 school weeks of daily swimming lessons (45 minutes) in a chlorinated pool.
  
  
  METHODS
  Proportions of children with ear discharge and respiratory and opportunistic bacteria in the nasopharynx and middle ear.
  
  
  RESULTS
  Of 89 children randomly assigned to the swimming or non-swimming groups, 58 (26/41 swimmers and 32/48 non-swimmers) had ear discharge at baseline. After 4 weeks, 24 of 41 swimmers had ear discharge compared with 32 of 48 non-swimmers (risk difference, - 8% (95% CI, - 28% to 12%). There were no statistically significant changes in the microbiology of the nasopharynx or middle ear in swimmers or non-swimmers. Streptococcus pneumoniae and non-typeable Haemophilus influenzae were the dominant organisms cultured from the nasopharynx, and H. influenzae, Staphylococcus aureus and Pseudomonas aeruginosa were the dominant organisms in the middle ear.
  
  
  CONCLUSIONS
  Swimming lessons for Aboriginal children in remote communities should be supported, but it is unlikely that they will substantially reduce rates of chronic suppurative otitis media and associated bacteria in the nasopharynx and middle ear. However, swimming was not associated with increased risk of ear discharge and we found no reason to discourage it.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12613000634774.
authors.affiliation: Child Health Division, Menzies School of Health Research, Royal Darwin Hospital, Darwin, NT, Australia. anna.stephen@menzies.edu.au
authors.forename: Anna T N
authors.initials: AT
authors.lastname: Stephen
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Leach
authors.forename: Peter S
authors.initials: PS
authors.lastname: Morris
mesh_terms: D001315:Australia; D002648:Child; D002675:Child, Preschool; D005260:Female; D054879:Halogenation; D006801:Humans; D008297:Male; D009305:Nasopharynx / Q000382:microbiology; D010035:Otitis Media, Suppurative / Q000208:ethnology* / Q000382:microbiology / Q000517:prevention & control*; D013550:Swimming; D013551:Swimming Pools; D018058:Tympanic Membrane Perforation / Q000150:complications* / Q000208:ethnology; D018508:Water Purification