| Summary: | Audiologic assessments for school-age Inuit children were conducted during the course of the school year to determine the fluctuation of hearing thresholds and prevalence of otitis media (OM) over three seasons, and to evaluate the relation between environmental and health variables with OM and conductive hearing impairment. For the 96 children evaluated at all three visits, hearing thresholds were statistically better in the Winter months, but the actual differences measured were small. Clinically, all 96 subjects had stable hearing thresholds over the school year. Environmental and health variables were measured for 112 Inuit children to assess the relation of these variables to the presence of long-term complications and sequelae associated with OM. The variables of gender, number of smokers in the home, infant feeding practices, school attendance schedule, number of residents in the home, number of wage earners in the family, inoculation for Haemophilus influenzae type b (Hib) disease, and age of inoculation for Hib disease were not associated with the presence of long-term complications and sequelae associated with OM. A history of 5 months of OM involvement by 1 year-of-age was a statistically significant predictor for children who had long-term middle ear disease. In addition, children who had experienced their first perforation by 6 months-of-age were statistically more likely to have long-term complications related to middle ear disease. The results of the present study indicated statistically significant criteria for the development of a high risk register for OM. These results support the need for early intervention for Inuit children who are at risk for long-term middle ear disease. A comprehensive program should include referral to audiology, otolaryngology, frequent home visits by community health care workers to facilitate continued education regarding OM and compliance with medical treatment, and monthly otoscopic and impedance tests performed by the community nurse practitioners. Through these efforts the prevalence of OM among Inuit children may decrease in the future.
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