Epidemiology of acute suppurative otitis media.

The incidence of acute otitis media in childhood reported in the literature varies considerably, particularly for children in the first year of life. In three cohorts of otherwise healthy children, followed from birth to the age of 9 years, the authors have attempted to determine more accurately the incidence and prevalence of acute otitis media in childhood. The incidence is highest in the first year of life, at about 22 per cent, after which time it gradually decreases from 15 per cent in the second and 10 per cent in the third and fourth years of life to 2 per cent in the eighth year. By the end of the third year of life, 50 per cent of all children have had at least one episode of acute otitis media; by the age of 9 years, 75 per cent have had an episode. The prevalence is almost constant at about 25 per cent during the first five years of life, dropping to 7 per cent during the eighth and ninth years of life. For the entire series, no sexual differences could be demonstrated with regard to incidence and prevalence of acute otitis media. By far, the majority of attacks (80 per cent) during the first two years were bilateral, whereas after the sixth year of life, 86 per cent of the children experienced unilateral disease.