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Missed opportunities for a diagnosis of acute otitis media in Aboriginal children

Gibney, Katherine B., Morris, Peter S., Carapetis, Jonathan R., Skull, Susan A. and Leach, Amanda J. (2003). Missed opportunities for a diagnosis of acute otitis media in Aboriginal children. Journal of Paediatrics and Child Health,39(7):540-542.

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Title Missed opportunities for a diagnosis of acute otitis media in Aboriginal children
Author Gibney, Katherine B.
Morris, Peter S.
Carapetis, Jonathan R.
Skull, Susan A.
Leach, Amanda J.
Journal Name Journal of Paediatrics and Child Health
Publication Date 2003
Volume Number 39
Issue Number 7
ISSN 1034-4810   (check CDU catalogue open catalogue search in new window)
Start Page 540
End Page 542
Total Pages 3
Place of Publication UK
Publisher Wiley-Blackwell Publishing
Language English
Field of Research 1114 - Paediatrics and Reproductive Medicine
HERDC Category C1 - Journal Article (DEST)
Abstract OBJECTIVE: Severe otitis media and its sequelae are common in rural and remote Aboriginal children. Identification of acute otitis media (AOM) is likely to reduce the number of children who go on to develop chronic suppurative otitis media and associated complications. The aim of this study was to compare the diagnoses made by researchers with that documented in the medical records of children admitted to the paediatric isolation ward of the Royal Darwin Hospital, Darwin, Northern Territory. METHODS: Children aged >8 years admitted to Royal Darwin Hospital were eligible for assessment by pneumatic otoscopy, video-otoscopy and tympanometry. A diagnosis was made for each child according to the state of their worst ear. Comparisons were made between the researcher diagnoses of ear disease and those documented in the hospital notes by medical staff. RESULTS: Thirty-one children were enrolled during 32 admissions. Most were aged >2 years, Aboriginal, and resided in remote communities. Sixty-one video-otoscopic assessments were attempted and sufficiently good images to allow diagnosis were obtained in 105 of 122 ears. Acute otitis media was diagnosed by the research team in 20 of 32 child admissions. Of 29 children who had ear examinations documented by hospital staff, only seven had a diagnosis of AOM recorded. Overall, the research team were almost three times more likely to make this diagnosis (relative risk 2.9, 95% confidence interval 1.6, 5.2). This difference was unlikely to have occurred by chance (P = 0.0002, McNemar's Chi-squared test). CONCLUSIONS: In this small study, young Aboriginal children with clear bulging of their tympanic membrane were not diagnosed with AOM by medical staff. Further training in diagnosis, including cleaning of the ear canal, may lead to more accurate assessment and appropriate recommendations for ongoing management.
Keywords Australia
otitis media
remote communities
DOI   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes 3923 (Journal) DA - 20030912IS - 1034-4810 (Print)LA - engPT - Journal ArticleSB - IM
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Created: Mon, 17 Dec 2007, 09:02:11 CST