URTI risk factor for chronic, recurrent otitis media

Feb 3 2014

Results from a meta-analysis indicate that upper respiratory tract infection (URTI) increases the odds of chronic or recurrent otitis media (COM or ROM) over sixfold.

The findings, published in PLoS One, also show that allergy or atopy, snoring, exposure to passive smoking and a history of acute otitis media (AOM) are all risk factors for the condition.

“Using a meta-analysis design applying strict diagnostic and inclusion criteria, we performed a reliable study to investigate the risk factors associated with the disease,” explain authors Min Xu (Xi’an Jiatong University School of Medicine, China) and colleagues.

They included 24 studies from between 1986 and 2011, of which between two and nine could be used to calculate pooled odds ratios of COM and ROM risk.

The researchers found that URTI (including the presence of cough, rhinorrhoea, nasal stuffiness, sore throat or adenoiditis/adenoid hypertrophy) was associated with a 6.59-fold increased odds of COM/ROM.

And, a history of AOM or ROM were associated with an 11.13-fold increased odds of COM/ROM.

Meanwhile, snoring was associated with a 1.96-fold increased odds of COM/ROM, exposure to passive smoking with a 1.39-fold increased risk and low social status with a 3.82-fold increased risk.

Factors that did not show a significant association with COM/ROM included chronic nasal obstruction, family history of otitis media, attending day centres and mother’s smoking during pregnancy. Additionally, associations between any breastfeeding and breastfeeding for over 6 months with a decreased risk for COM/ROM were not significant.

The authors say that theirs is the first meta-analysis to explore the risk factors for COM/ROM.

“A full understanding of the etiologic factors for COM/ROM could be beneficial for the treatment and prevention of the disease,” comment Xu et al. They suggest that strategies to tackle the identified risk factors could “prevent and decrease the onset of the disease”.

The team adds: “Other unidentified risk factors investigated in single studies need possible repeated studies with critical criteria to be estimated properly.”

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