PMC

The proportion of acute otitis media patients with 95% CI among all outpatients showing acute illness. 1B. The black bar and gray bar indicate the number of acute otitis media patients and all outpatients with acute illness, respectively. AOM, acute otitis media.

Conductive hearing loss health state diagram.
This health state transition diagram shows a schematic of the microsimulation model, where each circle represents a distinct health state and arrows represent transition probabilities. This figure illustrates the health states related to otitis media and conductive hearing loss in the simulation model. Simulated persons experience yearly probabilities of at least one episode of acute otitis media (AOM) and otitis media with effusion (OME) ≥3 months in the No HL state. A proportion of these patients might transition to the recurrent acute otitis media and persistent otitis media with effusion health state (rAOM, pOME). Patients with recurrent acute otitis media or persistent otitis media with effusion have a yearly probability of acquiring chronic suppurative otitis media (CSOM). After CSOM resolution (average of 3 years), simulated persons may resolve with no permanent conductive hearing loss, or transition to permanent conductive hearing loss. Non-otitis-media-related causes of conductive hearing loss are modeled in aggregate. All patients with conductive hearing loss have the potential to acquire sensorineural hearing loss each year. We assume that, once acquired, conductive and sensorineural hearing loss persist for the remaining lifetime. For simplicity, treated states and an absorbing health state, death, are not shown.
AOM: acute otitis media, CHL: conductive hearing loss, CSOM: chronic suppurative otitis media, pOME: persistent otitis media with effusion, HL: hearing loss, rAOM: recurrent acute otitis media, SNHL: sensorineural hearing loss.

Otitis media is a multifactorial disease. Specific host and environmental factors put children at risk for otitis media through various mechanisms, as illustrated in this diagram. Reducing the burden of otitis media will therefore require attention to more than a single risk factor. Given the complex causal pathways for otitis media, public health interventions may need to be prioritized differently for various at-risk populations and geographical regions. URTI, upper respiratory tract infection. Data from Refs –.

Literature search and selection. AOM acute otitis media, AOMwP acute otitis media with perforated tympanic membrane, CSOM chronic suppurative otitis media, OME otitis media with effusion