Published online January 2, 2008
PEDIATRICS Vol. 121 Supplement January 2008, pp. S98-S99 (doi:10.1542/10.1542/peds.2007-2022X)
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gunasekera, H.
Right arrow Articles by Craig, J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Gunasekera, H.
Right arrow Articles by Craig, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

COMMUNITY PEDIATRICS


MANAGEMENT OF CHILDREN WITH OTITIS MEDIA: A SURVEY OF AUSTRALIAN ABORIGINAL MEDICAL SERVICES

Hasantha Gunasekeraa, Peter Morrisb, John Danielsc, Sophie Couzosd and Jonathan Craige

a Children's Hospital at Westmead, Sydney, Australia
b Menzies School of Health Research, Darwin, Australia
c Redfern Aboriginal Medical Service, Sydney, Australia
d National Aboriginal Community Controlled Health Organisation, Townsville, Australia
e School of Public Health, University of Sydney, Sydney, Australia

ABSTRACT

INTRODUCTION: Otitis media remains one of the most common reasons for childhood primary health care presentations. Indigenous children are at the highest risk, but there are scarce data on how they are managed.

OBJECTIVE: We sought to determine how Australian primary health care medical practitioners diagnose and manage otitis media in Indigenous and non-Indigenous children.

METHODS: We contacted all of Australia's Aboriginal Medical Services by using the national government's register to identify their medical practitioners. We mailed a pilot 5-page clinical vignette questionnaire instrument to these primary health care practitioners (N = 257). Responses for Indigenous children were compared with those for non-Indigenous children.

RESULTS: Questionnaires were returned from 40.9% of medical practitioners (105 of 257) and 64.8% (57 of 88) of the nation's Aboriginal Medical Services. When examining children, practitioners used otoscopy (99.0% often/always) but not pneumatic otoscopy (67.0% never) or tympanometry (55.8% never). When practitioners diagnosed acute otitis media, they were more likely to use antibiotics (104 of 113 [92.0%]) when the child was Indigenous versus non-Indigenous (53 of 112 [47.3%]) (odds ratio: 12.9 [95% confidence interval: 5.9–27.9]). Amoxicillin was the most common antibiotic used (309 of 356 [86.8%]). The major factors that determined the practitioners' otitis media antibiotic use were Indigenous status (65.7%), wet perforations (63.7%), bulging tympanic membranes (58.3%), and fever (56.3%). The major factors for choosing no antibiotics were dry perforations (35.3%) and a well child (24.8%). Most practitioners were aware of the national guidelines (97.1%) but not the guidelines for Indigenous children (47.0%).

CONCLUSIONS: Aboriginal Medical Service practitioners rely on otoscopy alone to diagnose otitis media and are more likely to use antibiotics for Indigenous children despite not knowing the guidelines.

Submitted by Hasantha Gunasekera


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?