Lanphear B P, Byrd R S, Auinger P, Hall C B
Departments of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Pediatrics. 1997 Mar;99(3):E1. doi: 10.1542/peds.99.3.e1.
The number of visits for otitis media, the most common diagnosis among preschool children, has increased during the past decade. This study was undertaken to determine whether there has been a concurrent increase in the prevalence of recurrent otitis media among children in the United States and to identify risk factors or demographic changes to explain the increase.
Secondary analyses of cross-sectional data from the Child Health Supplement to the 1981 and 1988 National Health Interview Surveys (n = 5189 [1981] and n = 6209 [1988]) were done to identify temporal changes in the prevalence and any associated risk factors of recurrent otitis media among children <6 years of age.
Recurrent otitis among preschool children increased from 18.7% in 1981 to 26% in 1988 (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.4, 1.7). Although the prevalence of recurrent otitis increased with age, the greatest increase in recurrent otitis media occurred in infants (OR = 1.9, CI = 1.3, 2.9). Factors independently associated with recurrent otitis were any allergic condition (OR = 1. 9, CI = 1.7, 2.2); survey year (OR = 1.7, CI = 1.5, 1.9); Black race (OR = .6, CI = .5, .7); Hispanic ethnicity (OR = .8, CI = .6, .9); day care (OR = 1.5, CI = 1.3, 1.7); out-of-home care by an unrelated sitter (OR = 1.3, CI = 1.1, 1.6); and male gender (OR = 1.2, CI = 1. 1, 1.3). From 1981 to 1988, there were significant increases in some risk factors associated with recurrent otitis media, including day care (11% vs 21%) and allergic conditions (14% vs 18%).
We conclude that there has been a significant increase in the prevalence of recurrent otitis media among children in the United States, particularly in infants. The increased prevalence of recurrent otitis media was associated with an increase in the use of child care and a higher prevalence of allergic conditions among children.
在过去十年中，中耳炎是学龄前儿童最常见的诊断疾病，其就诊次数有所增加。本研究旨在确定美国儿童复发性中耳炎的患病率是否同时上升，并找出危险因素或人口统计学变化来解释这一增长。
对1981年和1988年《国家健康访谈调查》儿童健康补充调查的横断面数据进行二次分析（1981年n = 5189，1988年n = 6209），以确定6岁以下儿童复发性中耳炎患病率的时间变化以及任何相关危险因素。
学龄前儿童复发性中耳炎的患病率从1981年的18.7%上升至1988年的26%（优势比[OR]=1.6，95%置信区间[CI]=1.4，1.7）。虽然复发性中耳炎的患病率随年龄增长而增加，但复发性中耳炎增加最多的是婴儿（OR = 1.9，CI = 1.3，2.9）。与复发性中耳炎独立相关的因素包括任何过敏状况（OR = 1.9，CI = 1.7，2.2）；调查年份（OR = 1.7，CI = 1.5，1.9）；黑人种族（OR = 0.6，CI = 0.5，0.7）；西班牙裔（OR = 0.8，CI = 0.6，0.9）；日托（OR = 1.5，CI = 1.3，1.7）；由非亲属保姆提供的家庭外照料（OR = 1.3，CI = 1.1，1.6）；以及男性（OR = 1.2，CI = 1.1，1.3）。从1981年到1988年，与复发性中耳炎相关的一些危险因素显著增加，包括日托（11%对21%）和过敏状况（14%对18%）。
我们得出结论，美国儿童复发性中耳炎的患病率显著上升，尤其是在婴儿中。复发性中耳炎患病率的增加与儿童保育使用的增加以及儿童过敏状况患病率的上升有关。
