Poor living conditions blamed for chronic ear infections in Aboriginal kids
**EMBARGOED UNTIL 12 NOON SUNDAY AUGUST 18, 2002
The proportion of children with chronic ear infections leading to hearing loss problems in many Aboriginal communities is well in excess of levels regarded by the World Health Organization (WHO) as indicative of a massive public health problem, according to an Editorial in the latest issue of the Medical Journal of Australia
Clinical Associate Professor and Paediatric Otolaryngologist, Harvey Coates, from the Princess Margaret Hospital for Children in Subiaco, WA, and Dr Peter Morris, from the Menzies School of Health Research, Darwin, evaluated the ramifications of these high rates of chronic suppurative otitis media (CSOM) in Aboriginal children.
Up to half of remote-living Aboriginal children have conductive hearing loss as a result of CSOM.
The early exposure of Aboriginal infants to repeated bacterial infections leads to inflammation and tissue damage, and chronic mucosal disease.
Dr Coates said: "This begins a vicious cycle that may persist throughout childhood. Such infants themselves become chronic carriers and pose a risk to other, younger infants."
Bulging of the tympanic membrane is the best diagnostic predictor of eardrum perforation. Other signs and symptoms of acute otitis media including pain, fever, irritability or redness of the tympanic membrane are frequently absent amongst Aboriginal children.
Dr Coates said the implications of this lack of signs or symptoms is that parents do not recognise that their child is unwell, and the child remains untreated.
Effective primary prevention strategies have been identified. These include improving nutrition and the home environment, increasing breastfeeding, and reducing passive smoking, said Dr Coates.
In children with CSOM, high doses and prolonged courses of antibiotics are required. Where appropriate primary healthcare interventions have failed, access to surgical intervention can improve hearing outcomes. However, access to such specialist care for children in remote Aboriginal communities is inadequate.
The National Aboriginal Community Controlled Health Organisation (NACCHO) reports that the hearing health needs of Aboriginal children are not being met due to an inequitable distribution of funds from the Commonwealth Hearing Health Services Program.
Finally, Dr Coates added that the research priority is to determine the best use of preventative strategies and interventions — including educational, medical, surgical and audiological initiatives.
"Only with urgent attention to improving housing and access to running water, nutrition and quality of care, will this massive public health problem be solved,"
Dr Coates said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: (Editorial) Dr Harvey Coates (08) 9389 1622 (B/H)
- (08) 9335 5808 (A/H)
- Dr Sophie Couzos (0417) 178 514
NACCHO, W.A.
Sarah Crichton, AMA (0419) 440 076