This article is the final in our three-part series on blinding, deafening and sometimes deadly conditions in Indigenous Australian children that have little to no impact on their non-Indigenous counterparts. The previous articles looked at trachoma and rheumatic heart disease.
Aboriginal children have the highest rates of otitis media, a middle ear infection that causes hearing loss, than any other people in the world.
The main forms of the disease include acute otitis media, also known as a bulging eardrum; otitis media with effusion, commonly known as glue ear; and chronic suppurative otitis media, known as runny ear, which describes the pus discharged when a bulging eardrum bursts.
In 1996 – the most recent year comparative global data is available – the World Health Organisation reported that the prevalence chronic otitis media was highest in the Inuit (Eskimo) and Australian Aboriginal populations: at around 12% to 46%.
This was followed by Native Americans at 4% to 8%; South Pacific Islanders, Africans, Koreans and Indians at around 2% to 6%; and was lowest in United States and United Kingdom, at less than 1%.
The World Health Organisation considers a prevalence of 4% in the population of runny ears or chronic otitis media as a massive public health problem requiring urgent attention. Tragically, almost all Aboriginal children (90%) in remote areas have some form of otitis media: 50% have glue ear, 30% have acute otitis media, and around 15% have runny ears.Marianna Massey/AAP Image
Hearing loss and life trajectory
Otitis media is caused by multiple strains of three bacteria: Streptococcus pneumoniae, non-typeable Haemophilus infleunzae and Moraxella catarrhalis. These are common in the nasal passages of young children.
Indigenous children are at a significantly higher risk of otitis media and hearing loss compared to non-Indigenous children. One study found Indigenous children were five times more likely to be diagnosed with severe otitis media than their non-Indigenous counterparts. During the eight-year period studied, Indigenous children saw the GP for discharge in their ear 40 times more than non-Indigenous children.
The longer the infection is left untreated, the further risk it poses to hearing. The hearing loss associated with otitis media causes delayed language and speech, behavioural problems and social isolation; poor school attendance and low levels of literacy and numeracy; poor employment opportunities and increased poverty.
In fact, the issue of hearing is the most prevalent barrier to educational attainment for Indigenous children in the Northern Territory. In the NT in 2007 to 2011, 53% of Indigenous children receiving audiology services had some kind of hearing loss and 33% had a hearing impairment.
Shockingly, around 90% of Indigenous people incarcerated in the Northern Territory have hearing loss, which may have influenced their trajectory or compromised their communications with the justice system.
Authors: Amanda Leach, Professor. Leader of the Ear Health Research Program (EHRP), Child Health Division, Menzies School of Health Research