Otitis media in indonesian urban and rural school children

Pediatr Infect Dis J. 2014 Oct;33(10):1010-5. doi: 10.1097/INF.0000000000000366.


Background: Although the epidemiology of otitis media is well-known in industrialized countries, the extent of otitis media in developing Asian countries, especially in south East Asia is not well studied.

Methods: To define the burden of otitis media and its sequelae in children 6-15 years of age, we enrolled elementary and junior high school children in 6 areas in rural and urban Indonesia. Randomly selected schools and classrooms were selected. All children were administered a questionnaire and had ear examinations, pneumatic otoscopy and screening audiometry. Children with any abnormality on examination or with a relevant history underwent diagnostic audiometry and tympanometry, if indicated.

Results: Of the 7005 children studied, 116 had chronic suppurative otitis media (CSOM), 30 had acute otitis media and 26 had otitis media with effusion. 2.7% of rural children had CSOM compared with 0.7% of urban children (P < 0.0001). The rates per 1000 of CSOM in rural Bali and Bandung were significantly higher (75 and 25, respectively) than in the rest of Indonesia (P < 0.05). In rural Bali, the rate per 1000 children of inactive CSOM was 63 in 6- to 9-year-old children, compared with 37 in children aged 13-15 years. Concomitantly, the rates of tympanosclerosis were 7 and 26/1000, respectively, in these age groups.

Conclusions: In Indonesia, the prevalence of CSOM is relatively high with most disease occurring in rural areas. The high rates in rural Bali with early progression to tympanosclerosis suggest a significant burden of potentially vaccine preventable illness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acoustic Impedance Tests
  • Adolescent
  • Audiometry
  • Child
  • Female
  • Humans
  • Indonesia / epidemiology
  • Male
  • Otitis Media / diagnosis
  • Otitis Media / epidemiology*
  • Otoscopy
  • Prevalence
  • Prospective Studies
  • Rural Population*
  • Students
  • Surveys and Questionnaires
  • Urban Population*