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2015 ; 10
(4
): e0121572
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Parent-reported symptoms of acute otitis media during the first year of life:
what is beneath the surface?
#MMPMID25849847
Fortanier AC
; Venekamp RP
; de Hoog ML
; Uiterwaal CS
; van der Gugten AC
; van der Ent CK
; Hoes AW
; Schilder AG
PLoS One
2015[]; 10
(4
): e0121572
PMID25849847
show ga
BACKGROUND: Most estimates of the incidence of acute otitis media (AOM) are based
on general practitioner (GP) or pediatrician diagnoses. It is likely that these
figures underestimate the community incidence of AOM since parents do not visit
their doctor every time their child suffers from acute ear symptoms. The impact
of these symptom episodes may be substantial since they affect the child's
quality of life and parents' productivity. METHODS: To determine AOM symptoms in
the community, we measured parent-reported AOM symptoms daily for 12 consecutive
months in 1,260 children participating in a prospective birth cohort in the
Netherlands. The mean age of these children was at study enrollment 0.9 months
(standard deviation 0.6). A parent-reported AOM symptom episode was defined as
fever (temperature 38?C or above) plus at least one of the following symptoms:
ear pain and ear discharge. These febrile AOM symptom episodes were linked to
GP-consultations and diagnoses in the GP electronic health records. RESULTS: With
an estimated 624 parent-reported symptom episodes per 1,000 child-years (95% CI:
577 to 674) incidence of febrile AOM symptoms during the child's first year is
high. The GP was consulted in half of these symptom episodes and AOM was
diagnosed in 49% of these consultations. CONCLUSIONS AND RELEVANCE: The incidence
of febrile AOM symptoms in the first year of life is high in Dutch children and
leads to a GP-consultation in only half of the cases. This suggests that AOM
symptomatology in the community is underestimated when focusing on GP-diagnosed
AOM episodes alone, since a considerable proportion of febrile AOM symptom
episodes are treated symptomatically by parents at home and do not come to the
attention of the GP. Having data on community AOM symptomatology available for
each country is important when the potential impact of preventive and therapeutic
interventions for AOM are studied.