Prospective surveillance for otitis media with effusion among black infants in group child care.

Abstract

To document the prevalence of otitis media with effusion (OME) in 102 black children observed prospectively between 6 and 24 months of age. Study children attended nine different center-based child care facilities. Middle ear status was assessed by pneumatic otoscopy and tympanometry every 2 weeks. All children, except one, had OME during the period of observation. The proportion of child-examinations revealing bilateral OME ranged from 76% between 6 and 12 months of age to 30% between 21 and 24 months of age. Effusions were considered purulent in only 13% of examinations revealing middle ear fluid. The mean incidence of purulent OME was 2.13 episodes per child per year. Sixty-six children had at least 4 months of continuous bilateral OME during the period of observation; 57 were followed without placement of tympanostomy tubes. Bilateral OME had resolved before the second birthday in 95% of these children, and within 3 months of achieving the 4-month criterion in 50% of subjects. Persistent bilateral OME occurs commonly between 6 and 18 months of age in infants who enter group child care during the first year of life. In this study, spontaneous resolution of bilateral effusion by 2 years of age was typical.