Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

Pneumococcal vaccination and otitis media in Australian Aboriginal infants: comparison of two birth cohorts before and after introduction of vaccination

Mackenzie, Grant A., Carapetis, Jonathan R., Leach, Amanda J. and Morris, Peter S. (2009). Pneumococcal vaccination and otitis media in Australian Aboriginal infants: comparison of two birth cohorts before and after introduction of vaccination. BMC Pediatrics,9(1):23-33.

Document type: Journal Article
Attached Files (Some files may be inaccessible until you login with your CDU eSpace credentials)
Name Description MIMEType Size Downloads
Read with bookreader Download this reading  Mackenzie_24390.pdf Published version application/pdf 651.36KB 36
Reading the attached file works best in Firefox, Chrome and IE 9 or later.

IRMA ID 10414xPUB37
Title Pneumococcal vaccination and otitis media in Australian Aboriginal infants: comparison of two birth cohorts before and after introduction of vaccination
Author Mackenzie, Grant A.
Carapetis, Jonathan R.
Leach, Amanda J.
Morris, Peter S.
Journal Name BMC Pediatrics
Publication Date 2009
Volume Number 9
Issue Number 1
ISSN 1471-2431   (check CDU catalogue open catalogue search in new window)
Start Page 23
End Page 33
Total Pages 11
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background
Aboriginal children in remote Australia have high rates of complicated middle ear disease associated with Streptococcus pneumoniae and other pathogens. We assessed the effectiveness of pneumococcal vaccination for prevention of otitis media in this setting.

Methods

We compared two birth cohorts, one enrolled before (1996–2001), and the second enrolled after introduction of 7-valent pneumococcal conjugate and booster 23-valent polysaccharide vaccine (2001–2004). Source populations were the same for both cohorts. Detailed examinations including tympanometry, video-recorded pneumatic otoscopy and collection of discharge from tympanic membrane perforations, were performed as soon as possible after birth and then at regular intervals until 24 months of life. Analyses (survival, point prevalence and incidence) were adjusted for confounding factors and repeated measures with sensitivity analyses of differential follow-up.

Results

Ninety-seven vaccinees and 51 comparison participants were enrolled. By age 6 months, 96% (81/84) of vaccinees and 100% (41/41) of comparison subjects experienced otitis media with effusion (OME), and by 12 months 89% and 88% experienced acute otitis media (AOM), 34% and 35% experienced tympanic membrane perforation (TMP) and 14% and 23% experienced chronic suppurative otitis media (CSOM). Age at the first episode of OME, AOM, TMP and CSOM was not significantly different between the two groups. Adjusted incidence of AOM (incidence rate ratio: 0.88 [95% confidence interval (CI): 0.69–1.13]) and TMP (incidence rate ratio: 0.63 [0.36–1.11]) was not significantly reduced in vaccinees. Vaccinees experienced less recurrent TMP, 9% (8/95) versus 22% (11/51), (odds ratio: 0.33 [0.11–1.00]).

Conclusion

Results of this study should be interpreted with caution due to potential bias and confounding. It appears that introduction of pneumococcal vaccination among Aboriginal infants was not associated with significant changes in prevalence or age of onset of different OM outcomes or the incidence of AOM or TMP. Vaccinees appeared to experience reduced recurrence of TMP. Ongoing high rates of complicated OM necessitate additional strategies to prevent ear disease in this population.

Keywords middle ear disease
pneumococcal vaccination
Aboriginal infants
DOI http://dx.doi.org/10.1186/1471-2431-9-14   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


© copyright

Every reasonable effort has been made to ensure that permission has been obtained for items included in CDU eSpace. If you believe that your rights have been infringed by this repository, please contact digitisation@cdu.edu.au.

 
Versions
Version Filter Type
Access Statistics: 44 Abstract Views, 43 File Downloads  -  Detailed Statistics
Created: Tue, 23 Oct 2012, 12:07:52 CST by Iwona Rohoza