1c:I[419806,["/_next/static/chunks/bb923814e1f4d2e9.js","/_next/static/chunks/dd3ee9f5b7716ca6.js","/_next/static/chunks/4204a0ae82542ca8.js","/_next/static/chunks/30036bedc5269936.js","/_next/static/chunks/6e1aa89a642f40be.js","/_next/static/chunks/cd5e572bc3e4eb92.js","/_next/static/chunks/8ffd0b71567920d8.js","/_next/static/chunks/67ea6dfd21f16c5f.js","/_next/static/chunks/24eb4379f68013fd.js","/_next/static/chunks/b8cd775ffdf935bd.js","/_next/static/chunks/983103cd9eb7b428.js","/_next/static/chunks/d4ac9dcf27f6ff52.js","/_next/static/chunks/294b9525248c8e5f.js"],"default"] 1d:T496,Otitis media (OM) develops in the first months of life and persists throughout childhood in many rural Aboriginal children. We have followed Aboriginal and non-Aboriginal infants from birth to determine the relationship of the early onset of OM to nasopharyngeal colonization with respiratory pathogens. Aboriginal infants were colonized with multiple species of respiratory bacteria (Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae) at a rate of 5% per day and the timing of colonization predicted the onset of persistent OM in individual Aboriginal infants. Non-Aboriginal infants became colonized by M. catarrhalis alone at the slower rate of 1% per day and experienced transient episodes of OM in the absence of colonization. We attribute early bacterial colonization in most Aboriginal infants to high rates of cross-infection due to overcrowding, poor hygiene and high rates of bacterial carriage. Early age of infection and the multiplicity of bacterial types may contribute to prolonged carriage and to eustachian tube damage leading to persistent OM. Thus Aboriginal infants are "otitis-prone" and might qualify for prophylactic antibiotics.1e:T40c,ACUTE otitis media is a common problem in infants and children. Although antibiotics seem to be effective in controlling suppurative complications, otitis is still a significant cause of morbidity and hearing loss. The etiology remains unsettled and treatment is largely empirical. Bacteriologic studies have repeatedly demonstrated that in only 60% to 70% of cases is it possible to isolate a pathogen from middle ear fluid.^1-5Unproved explanations for the sterility of the remaining 30% to 40% are diverse and include a possible viral etiology.⁵There have been only sporadic accounts of virus isolation from middle ear fluid; few systematic attempts to isolate virus from middle ear fluid have been reported.^5-8The association ofMycoplasmawith bullous myringitis has been observed in adult volunteers infected with artificially propagatedM pneumoniae.⁹In naturally acquiredMpneumoniaeinfection the organism has been recovered on several occasions from the middle1f:T417,[Extract] In developed countries, otitis media with effusion is the commonest cause of conductive hearing loss in children. In developing countries, on the other hand, acute and chronic suppurative ear disease is much more prevalent and contributes to increased mortality.2 In 1995, chronic suppurative otitis media was considered to be the most important cause of hearing impairment in Africa.3 The World Health Organisation (WHO) recommended in 1991 that of all the causes of hearing impairment, priority should be given to the prevention and control of acute otitis media.4 \n \nThe pattern of ear disease in Aboriginal populations is consistent with that in developing countries. But here, ear disease contributes little to reduced Aboriginal life expectancy. Instead, it leads to persistent and chronic ear disease and subsequent hearing loss from early infancy - with a legacy of educational and social disadvantage. \n \nDisability associated with hearing impairment through chronic otitis media is a consequence of poverty.

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