Otago Medical School, The University of Otago, Wellington, New Zealand.
Medical Research Centre, School of Health, University of Waikato, Private Bag 3105, Hamilton 3240, New Zealand.
J Prim Health Care. 2023 Sep;15(3):224-229. doi: 10.1071/HC23026.
Introduction Acute otitis media (AOM) is a common condition of children encountered in general practice. A proportion of children develop otitis media with effusion (OME), which may require tympanostomy and ventilation tube insertion. Aim The aim of the study was to compare the incidence of AOM in Māori and New Zealand (NZ) European children in general practice and the referral practices to secondary care for tympanostomy and ventilation tube insertion. Methods The study was conducted in two parts: (1) an analysis of the incidence of AOM and OME in a rural Waikato general practice (Ōtorohanga) with a high Māori population over a 2-year period; and (2) an analysis of all referrals to the otorhinolaryngology (ORL) department at Waikato District Health Board and tympanostomy and ventilation tube insertion by this service over the same period. Results The incidence of AOM was similar in Māori compared with NZ European children. The incidence declined significantly between 2019 and 2020 and 50% of children with AOM were treated with antibiotics. Referral rates to the ORL department were greater for Māori compared with NZ European children as were tympanostomy and ventilation tube insertion rates. Discussion Although AOM is common, OME was rarely diagnosed. The clinical guidelines regarding antibiotic use for common conditions are not being readily adopted and further research is needed into this matter. The COVID-19 pandemic had a substantial effect on demand both in general practice and in the hospital sector. This may have been due to a reduction in the incidence of AOM or due to system changes caused by the pandemic.
引言 急性中耳炎(AOM)是普通科常见的儿童疾病。部分儿童会发展为分泌性中耳炎(OME),可能需要鼓膜切开术和通气管插入。 目的 本研究旨在比较普通科中毛利人和新西兰欧洲儿童 AOM 的发病率,以及转介至二级保健进行鼓膜切开术和通气管插入的情况。 方法 该研究分为两部分进行:(1)对高毛利人群的怀卡托农村普通科(奥托罗杭加)进行为期两年的 AOM 和 OME 发病率分析;(2)对怀卡托地区卫生局耳鼻喉科(ORL)部门同期的所有转介和该服务的鼓膜切开术和通气管插入情况进行分析。 结果 AOM 的发病率在毛利儿童中与新西兰欧洲儿童相似。2019 年至 2020 年间,发病率显著下降,50%的 AOM 患儿接受了抗生素治疗。与新西兰欧洲儿童相比,毛利儿童转介至 ORL 部门和接受鼓膜切开术和通气管插入的比例更高。 讨论 尽管 AOM 很常见,但 OME 很少被诊断出来。有关常见疾病抗生素使用的临床指南尚未被广泛采用,需要对此进行进一步研究。COVID-19 大流行对普通科和医院部门的需求都产生了重大影响。这可能是由于 AOM 的发病率降低,也可能是由于大流行导致的系统变化。