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Evidence summaries

Mode of Day Care, Number of Siblings and History of Otitis in the Family as Risk Factors for Acute Otitis Media

Day care outside the home, day care in a private home, number of siblings and occurrence of otitis in other family members are risk factors of acute otitis. Level of evidence: "A"

A meta-analysis by Uhari et al 1 included 22 studies that had examined the risk factors for acute otitis media in children. The most significant risk factors were occurrence of otites in other family members (risk ratio 2.63; 95% confidence interval (CI) 1.86 - 3.72) and day care outside the home (risk ratio 2.45; 95% CI 1.51 - 3.98). Day care in a private home with children from other families also increased the risk compared with care in the home (risk ratio 1.59; 95% CI 1.19 - 2.13). The existence of at least one sibling increased the risk of otitis markedly (risk ratio 1.92; 95% CI 1.29 - 2.95).

A study by Alho et al 2 followed 2 512 children from birth up to the age of two years. Also this study showed day care in a day care centre to be the most important risk factor for acute otitis media: odds ratio (OR) for developing at least three episodes of otitis was 1.9 (95% CI 1.6 - 2.2). The OR for day care in private families was 1.4 (95% CI 1.2 - 1.6) and the OR for the existence of at least two siblings was 1.3 (95% CI 1.1 - 1.4).

Comment: The quality of evidence is upgraded by large magnitude of effect and consistency.

References

  • Uhari M, Mäntysaari K, Niemelä M. A meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis 1996 Jun;22(6):1079-83. [PubMed]
  • Alho OP, Koivu M, Sorri M, Rantakallio P. Risk factors for recurrent acute otitis media and respiratory infection in infancy. Int J Pediatr Otorhinolaryngol 1990 Jun;19(2):151-61. [PubMed]

Primary/Secondary Keywords