The buck stops ear: Researchers hone-in on ear infection endemic

It’s the national health tragedy that’s falling on deaf ears: Aboriginal and Torres Strait Islander children have the highest rates of ‘otitis media’ – or middle ear infection – in the world.

Professor Jennifer Reath from Western Sydney University’s School of Medicine says the statistics on otitis media particularly in remote areas of Australia are not acceptable.

“90% of Aboriginal children who live in remote areas have some form of otitis media.”

“This level of infection is a significant health concern. In the long-term, it can result in hearing loss. Hearing loss can lead to delayed language development and speech, which can in turn lead to learning difficulties and behavioural problems and eventually to unemployment and poverty,” says Professor Reath.

Professor Reath says ear disease is also an issue for Aboriginal children in urban communities – yet little research has been undertaken in this area, and treatment guidelines are informed by studies of non-Indigenous children.

To address this major social and health concern, Western Sydney University researchers Professor Reath, Dr Penelope Abbott, Professor Wendy Hu and Associate Professor Federico Girosi are teaming up with Aboriginal Health Services and other researchers on two important studies.

The first study, ‘Watchful waiting for Aboriginal and Torres Strait Islander Children with acute otitis media’ – or the WATCH Trial – is investigating the most effective management of ear infections in urban Aboriginal children.

The National Health and Medical Research Council (NHMRC) funded WATCH Trial is currently underway within five urban Aboriginal and Torres Strait Islander Health Services – with Research Officers on each site working to identify children with ear infections.

Professor Reath, the lead researcher on the WATCH Trial, says the study will compare the costs and benefits of monitoring children who present with acute otitis media, with the alternate method of immediately treating ear infections with antibiotics.

“The ‘watchful waiting’ approach is typically used for non-Aboriginal children and is now recommended for urban Aboriginal children at low risk of complications. The antibiotic treatment option is recommended for Aboriginal children living in remote areas,” says Professor Reath.

“Preventing complications including perforation of the ear drum is always a key goal of treatment. However antibiotic resistance is growing in Aboriginal communities, so it’s important to determine if the method of immediately treating with antibiotics is the most effective approach.”

The second study, ‘A multi-centre randomised controlled trial to compare nasal balloon auto-inflation versus no nasal balloon auto-inflation for otitis media with effusion in Aboriginal and Torres Strait Islander children’ – or the INFLATE Trial.

This research has also been awarded NHRMC funding and commenced in late 2017. In the first research of this approach to treatment in Australia, the existing WATCH Research Officers in each participating health centre will also add to their investigations an innovative alternative to treating glue ear.

Dr Penny Abbott, also from the Western Sydney University’s School of Medicine, is the lead researcher for the INFLATE Trial. She says the study will determine if the use of a simple device – in which a child blows up a balloon with their nostrils – helps resolve glue ear and improves hearing.

“Glue ear is difficult to treat and the commonest cause of ‘grommet’ surgery. In the meantime children are often not hearing well and miss out on important learning at school and in the home,” says Dr Abbott.

“If the use of nasal balloon auto-inflation is found to be an effective treatment method, the results of the study could alter the recommended treatment methods for glue ear across the nation.”

The research team comprises pre-eminent researchers from across Australia including Associate Professor Kelvin Kong, Australia’s first Aboriginal ENT surgeon. Professor Reath notes “This research would not be possible without the expert and enthusiastic contribution  made by our Aboriginal Research Officers and the support of the Aboriginal Health Services who are partnering with us on this research.”

Professor Reath says Australia needs to listen up and recognise ‘otitis media’ as a national public health concern that requires urgent attention.

“With this set of studies, the research team at Western Sydney University and their Aboriginal Medical Service partners are leading the way in addressing one of our countries most pressing health concerns.”


26 February 2018

Danielle Roddick, Senior Media Officer.