Ethnic differences in otitis media [abstract]

The comparative incidence of Otitis Media (OM) has long been difficult to ascertain as almost all previous epidemiological studies were performed in comparatively homogenous populations. In an attempt to question the racial variation of OM, a study was done in Trinidad, with a population of 1.2 million people. About 40 percent of the population is of African ancestry, 40 percent of East-Indian ancestry and 20 percent includes persons of mixed ethnicity, Caucasian, Chinese and middle-Eastern descent. All patients who presented with acute otitis media (AOM), middle ear effusion (MEE), or chronic suppurative otitis media (CSOM) either of the tubo-tympanic (TT) or attico-antral (AA) types, during the period November 1998 to May 1999, were included in the study. The three national otolaryngology Departments participated in the study suggesting that patients were representative of the whole population. A questionnaire was devised with documented ethnic and other demographic factors. This was completed once an experienced physician diagnosed the patient with one of the above conditions. Two hundred and fifty-two patients enrolled in the study. There were 128 males and 124 females and the age range was 4 months to 83 years. Sixty patients presented with AOM, 88 with MEE and 104 with CSOM. The most interesting result was the ethnic distribution of the patients. One hundred and thirty-eight were of East-Indian descent and 71 were of African origin, a ratio of nearly 2:1. In conclusion, in a national population containing nearly equal numbers of two major ethnic groups, the East Indians presented twice as commonly as the Africans with otitis media. Various proposed reasons for this will be discussed. (AU)

Meniere's disease

Prosper Meniere more than 100 years ago in the clinical description of the disease complex that bears his name, has not been surpassed in clarity or in factual presentation of the symptoms of the disease. Modern day otorhino-laryngologists have a clearer view possibly of the condition because of more recently described specific pathology. Viz: episodic vertigo, tinnitus, hearing loss of sensorineural type due to cochlear damage(AU)

Asyptomatic maternal rubella and congenital deafness

A total of 139 congenitally deaf children were studied. Of these 87 were found to be born in the year of 1961. This sharp rise in the incidence of congenital deafness was associated with an epidemic of German measles in the latter part of 1960 and early 1961. Only 20 of these 87 cases gave a definite history of maternal rubella. (AU)

Subclinical maternal rubella and congenital deafness

At present 40 percent of congenital deafness is inexplicable. The effect of rubella on the frequency of congenital deafness was studied five years after an epidemic of rubella in an island population. Of 87 congenitally deaf children born in 1961, the year after the epidemic, 86 had deafness as the only demonstrable congenital abnormality. Only 20 gave a history of first-trimester rubella. By modern classification the remaining 67 cases should be labelled as idiopathic congenital deafness having been ruled out. Serologic tests for rubella antibodies on 30 of the idiopathic deaf children were positive in 74 per cent, as compared to 30 per cent in a control group born within the same year. This study suggests asymptomatic rubella infection in the first trimester as an etiologic factor in congenital deafness. (AU)