ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 9
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Acute otitis media – the challenges of AOM detection and
research in Aboriginal and Torres Strait Islander children
A/Prof Penny Abbott1, Caitlin Frede1, Prof Wendy Hu2, Sanja Lujic3, Steven Trankle1, Letitia Campbell4,
Hasantha Gunasekera5, Robyn Walsh1, Prof Amanda Leach6, Peter Morris6, Kelvin Kong7, E/Prof
Jennifer Reath1
1
Department of General Practice, Western Sydney University, 2Medical Education Unit, Western
Sydney University, 3Centre for Big Data Research in Health, University of New South Wales, 4Kalwun
Development Corporation, 5Children’s Hospital Westmead Clinical School, Sydney University, 6Child
Health Division, Menzies School of Health Research, 7School of Medicine and Public Health, University
of Newcastle
Aboriginal and Torres Strait Islander children experience a high burden of otitis media (OM) and
hearing impairment, which can affect development and quality of life for years. Early detection and
evidence-based management can improve the trajectory of these children through the early years
and beyond. During the first study of antibiotic management of acute OM management in urban
Aboriginal and Torres Strait Islander children, a GP diagnosis of acute OM (AOM) was made according
to stringent criteria (middle ear effusion, tympanic membrane bulge and/or pain). Two scales were
employed to monitor symptoms over time: the AOM-Severity of Symptoms scale (AOM-SOS) and
the AOM-Faces Scale (AOM-FS). Data were derived from 224 children aged 18 months to 16 years
(median 3.6 years) at Day 0, 7, and 14 post recruitment. We tabulated the symptoms and compared
the scale symptom scores for trends, correlation and responsiveness. Symptoms associated with
AOM at Day 0 were runny nose (40%), cough (38%) and irritability (36%). More than one-third had no or
minimal symptoms at Day 0 according to AOM-SOS (1–2/10) and AOM-FS scores (1–2/7). The scales
were moderately correlated at all study points. However, trends and mean scores were the same
whether AOM was judged as persistent or resolved at Day 7. Therefore, it is likely the scales measured
resolution of symptoms related to concurrent upper respiratory tract infections rather than symptoms
due to AOM. Monitoring symptoms is not an effective way of determining whether AOM is present
or resolved. Middle ear effusion and bulging of the tympanic membrane should be monitored using
tympanometry and otoscopy, rather than reliance on symptoms and scales when monitoring AOM
treatment among Aboriginal and Torres Strait Islander children.
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