A longitudinal study of risk factors for otitis media in African American children.

OBJECTIVE: Otitis media with effusion (OME) is a common health care problem for children. The purpose of this study was to examine factors that place children at risk for OME such as age, type of child care, number of people in the household, and smoking in the household. METHODS: Eighty-six African American children, enrolled in center-based child care in infancy, entered the study at a mean age of 8.2 months and were followed prospectively until 48 months of age. Ear status was documented biweekly using pneumatic otoscopy and tympanometry. Data on risk factors were collected every 6 months. RESULTS: Results indicated that children had a marked decrease in the proportion of time with OME between 6 and 48 months. The rate of OME decline was faster in the first 2.5 years than in subsequent years. Children in center-based child care showed a slightly slower rate of decline than did children in non-center-based care. Longitudinal analysis indicated that the age of the child and the number of other children in the household were significant predictors of OME. For each additional child under 12 years of age in the home, there was a 2% increase in the proportion of time with OME. CONCLUSION: While attendance in group child care predicted a risk for OME, children's age and the number of other children in the household were still contributing risk factors for OME.