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Trends in Otitis Media and Myringtomy With Tube Placement Among American Indian/Alaska Native Children and the US General Population of Children

Singleton, Rosalyn J. MD, MPH*†; Holman, Robert C. MS‡; Plant, Randall MD*; Yorita, Krista L. MPH‡; Holve, Steve MD§; Paisano, Edna L. MSW¶; Cheek, James E. MD, MPH∥

Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e318188d079
Original Studies
Abstract

Background: Otitis media (OM) morbidity in American Indian and Alaska Native (AI/AN) children is historically higher than that in other US children.

Methods: Outpatient visits and hospitalizations listing OM as a diagnosis and outpatient visits listing myringotomy with insertion of tubes as a procedure among AI/AN children <5 years of age from the Indian Health Service National Patient Information Reporting system for 2003–2005 were analyzed. Outpatient visits and hospitalizations with OM for the general US child population were analyzed using the National Hospital Ambulatory Medical Care and National Ambulatory Medical Care Surveys for 2003–2005, and the 2003 Kids’ Inpatient Database, respectively.

Results: The OM-associated outpatient visit rate for AI/AN children <5 years of age (89 per 100 children/yr) for 2003–2005 was less than that reported for 1994–1996 (138); however, the rate increased for Alaska region (158 to 181). The OM outpatient visit and myringotomy with insertion of tubes rates (181 and 2.6 per 100 children/yr, respectively) for AI/AN children in Alaska were higher than rates for children in each of the other IHS regions and rates for US children (63 and 1.8 per 100 children/yr, respectively). The OM outpatient visit rates for AI/AN infants (184), especially in the Alaska region (334), were higher than the rate for US infants (84).

Conclusions: The OM-associated outpatient visit rate in AI/AN children <5 years of age has decreased but remains higher than that of the US general child population; however, the rate increased in the Alaska region, where a limited decline in invasive pneumococcal disease has been demonstrated. The ongoing disparity in OM outpatient visit rates among AI/AN children, especially Alaska Native children, indicates a need for new prevention measures, including expanded-valency pneumococcal conjugate vaccines, to reduce OM morbidity.

Author Information

From the *Alaska Native Tribal Health Consortium, Anchorage, AK; †US Department of Health and Human Services, National Center for Preparedness Detection, and Control of Infectious Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK; ‡Division of Viral and Rickettsia1 Diseases, US Department of Health and Human Services, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA; §Pediatric Unit, Tuba City Regional Health Corporation, Tuba City, AZ; ¶Division of Program Statistics, Office of Public Health Support, Indian Health Service, Rockville, MD; and ∥Division of Epidemiology, US Department of Health and Human Services, Office of Public Health Support, Indian Health Service, Albuquerque, NM.

Accepted for publication August 01, 2008.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agencies.

Address for correspondence: Rosalyn Singleton, MD, AIP-CDC, 4055 Tudor Centre Dr., Anchorage, AK 99508. E-mail: ris2@cdc.gov.

© 2009 Lippincott Williams & Wilkins, Inc.