Onset of otitis media in the first eight weeks of life in aboriginal and non-aboriginal Australian infants.

Otitis media (OM) is highly prevalent among Aboriginal Australians, in whom eardrum perforations with discharge have been reported in the first 3 months of life. Only one published study, however, has described middle ear status at birth or prior to eardrum perforation in young Aboriginal infants. This prospective study used otoscopy, tympanometry, and hearing tests to compare middle ear status and hearing sensitivity in Aboriginal and non-Aboriginal neonates. Immobile eardrums were observed immediately after birth, but mobility generally appeared within the first week. At examinations at 6 to 8 weeks of age, OM with effusion or acute OM was observed in 95% of 22 Aboriginal infants, but OM with effusion was seen in only 30% of 10 non-Aboriginal infants. There was a clinic record of unilateral perforation in 1 Aboriginal infant only. Hearing impairment was demonstrated by auditory brain stem response in 5 ears, all with evidence of middle ear abnormalities. Improved knowledge and diagnosis of the signs and symptoms of OM will contribute to improvements in the provision of early medical intervention to populations at high risk for early OM.