Shaw J R, Todd N W, Goodwin M H, Feldman C M
Public Health Rep. 1981 Jul-Aug;96(4):342-9.
Studies were conducted to assess the relation of environmental and behaviora factors to occurrence of acute suppurative otitis media (ASOM) among four populations of Indian children in Arizona. Episodes of ASOM were recorded for 1,428 children observed during the first year of life. Data obtained on the households and premises of these children included number of persons in the household, number of sleeping rooms, type of water supply and sewage disposal, type of heating and cooling, availability of electricity, method of infant feeding, distance to a health facility, and mother's education. The rates of ASOM for the four populations ranged from 1.1 to 2.2 attacks per child and differed significantly from each other, with one exception. The differences between populations apparently were not related to any of the factors evaluated. Additional analyses to evaluate the association of each factor with occurrence of ASOM included (a) a comparison of rates among children living in homes having each factor with rates among children living in homes lacking the factor, (b) a comparison of the frequency of each factor in homes of children who had no recorded attacks of ASOM with the frequency in homes of children who had three or more attacks (high-risk children), and (c) an evaluation of the relation between frequency of encounters for ASOM and the environmental factors. Results did not indicate that any environmental or behavioral factor observed was consistently or strongly associated with either the incidence of ASOM or the frequency of attacks. Similarly, no differences were apparent in the frequency of adverse environmental conditions in homes of infants with contrasting rates of ASOM. Rates of ASOM during the first year of life were not associated with either the presence or the absence of adverse environmental conditions.
开展了多项研究，以评估环境因素和行为因素与亚利桑那州四个印度儿童群体中急性化脓性中耳炎（ASOM）发病情况之间的关系。记录了1428名在出生后第一年接受观察的儿童的ASOM发病情况。从这些儿童的家庭和居住场所收集的数据包括家庭人口数量、卧室数量、供水和污水处理类型、供暖和制冷类型、是否通电、婴儿喂养方式、到医疗机构的距离以及母亲的受教育程度。这四个群体的ASOM发病率在每个儿童1.1至2.2次发作之间，除一个例外情况外，彼此间差异显著。群体之间的差异显然与所评估的任何因素均无关。评估每个因素与ASOM发病之间关联的其他分析包括：（a）比较具有每个因素的家庭中儿童的发病率与缺乏该因素的家庭中儿童的发病率；（b）比较未记录有ASOM发作的儿童家庭中每个因素的出现频率与有三次或更多次发作的儿童（高危儿童）家庭中该因素的出现频率；（c）评估ASOM就诊频率与环境因素之间的关系。结果并未表明所观察到的任何环境因素或行为因素与ASOM发病率或发作频率始终存在强关联。同样，ASOM发病率不同的婴儿家庭中不良环境状况的出现频率也无明显差异。出生后第一年的ASOM发病率与是否存在不良环境状况均无关。
