Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
PLoS One. 2019 Apr 23;14(4):e0215483. doi: 10.1371/journal.pone.0215483. eCollection 2019.
Otitis media (OM) is one of the most common infectious diseases affecting children globally and the most common reason for antibiotic prescription and paediatric surgery. Australian Aboriginal children have higher rates of OM than non-Aboriginal children; however, there are no data comparing OM hospitalization rates between them at the population level. We report temporal trends for OM hospitalizations and in-hospital tympanostomy tube insertion (TTI) in a cohort of 469,589 Western Australian children born between 1996 and 2012.
We used the International Classification of Diseases codes version 10 to identify hospitalizations for OM or TTI recorded as a surgical procedure. Using age-specific population denominators, we calculated hospitalization rates per 1,000 child-years by age, year and level of socio-economic deprivation.
There were 534,674 hospitalizations among 221,588 children hospitalized at least once before age 15 years. Aboriginal children had higher hospitalization rates for OM than non-Aboriginal children (23.3/1,000 [95% Confidence Interval (CI) 22.8,24.0] vs 2.4/1,000 [95% CI 2.3,2.4] child-years) with no change in disparity over time. Conversely non-Aboriginal children had higher rates of TTI than Aboriginal children (13.5 [95% CI 13.2,13.8] vs 10.1 [95% CI 8.9,11.4]). Children from lower socio-economic backgrounds had higher OM hospitalization rates than those from higher socio-economic backgrounds, although for Aboriginal children hospitalization rates were not statistically different across all levels of socio-economic disadvantage. Hospitalizations for TTI among non-Aboriginal children were more common among those from higher socio-economic backgrounds. This was also true for Aboriginal children; however, the difference was not statistically significant. There was a decline in OM hospitalization rates between 1998 and 2005 and remained stable thereafter.
Aboriginal children and children from lower socio-economic backgrounds were over-represented with OM-related hospitalizations but had fewer TTIs. Despite a decrease in OM and TTI hospitalization rates during the first half of the study for all groups, the disparity between Aboriginal and non-Aboriginal children and between those of differing socioeconomic deprivation remained.
中耳炎（OM）是全球范围内最常见的传染病之一，也是抗生素处方和小儿手术最常见的原因。澳大利亚原住民儿童的 OM 发病率高于非原住民儿童；然而，目前还没有关于这两组人群在人口水平上 OM 住院率的比较数据。我们报告了在 1996 年至 2012 年间出生的 469589 名西澳大利亚儿童队列中 OM 住院治疗和院内鼓膜切开术（TTI）的时间趋势。
我们使用国际疾病分类第 10 版代码来识别 OM 或 TTI 的住院记录，作为手术程序。使用特定年龄的人口分母，我们按年龄、年份和社会经济贫困程度计算了每 1000 名儿童年的住院率。
在至少 15 岁前住院的 221588 名儿童中，有 534674 名儿童因 OM 住院。原住民儿童的 OM 住院率高于非原住民儿童（23.3/1000[95%置信区间（CI）22.8，24.0]与 2.4/1000[95%CI 2.3，2.4]儿童年），且这种差距在时间上没有变化。相反，非原住民儿童的 TTI 发生率高于原住民儿童（13.5[95%CI 13.2，13.8]与 10.1[95%CI 8.9，11.4]）。社会经济背景较低的儿童的 OM 住院率高于社会经济背景较高的儿童，但对于原住民儿童，住院率在所有社会经济劣势水平之间没有统计学差异。非原住民儿童的 TTI 住院率在社会经济背景较高的儿童中更为常见。对于原住民儿童来说也是如此；然而，这一差异没有统计学意义。OM 住院率在 1998 年至 2005 年期间下降，此后保持稳定。
原住民儿童和社会经济背景较低的儿童因 OM 相关住院治疗而过度代表，但 TTI 较少。尽管所有组在研究的前半段 OM 和 TTI 住院率都有所下降，但原住民和非原住民儿童以及社会经济贫困程度不同的儿童之间的差距仍然存在。
