Indigenous children have the highest reported rates of otitis media (OM), commonly known as middle ear infection, and burst eardrums in the world.

Nine out of 10 young Indigenous children who live in remote communities have some form of ear disease, and one in six has burst eardrum(s).

Long-term middle ear damage causes hearing loss, which impacts on the development of speech and language, and is linked to educational disadvantage and behavioural problems.

Our research focus:
  • We conduct prevention and treatment trials that assess which therapies work best for Indigenous children. These evidence-based trials influence policy and practice.
Our research impact:
  • Improving the diagnostic skills and management of OM in remote clinics will be aided by this updated guideline, prepared by the Menzies Ear Health Team, the Otitis Media Guidelines.
  • Children who carry high numbers of bacteria in their noses are more likely to suffer from severe ear disease. Treatments that reduce the density of bacteria may reduce the severity of infection, particularly eardrum perforation. Strategies that delay or prevent bacterial acquisition in the first months of life are needed – these may be through vaccination or improved living conditions.
  • The efficacy of azithromycin in resolving bulging eardrums is being evaluated in a randomised controlled trial (RCT).
  • In a RCT of daily swimming lessons, children with 'runny ears' were neither improved nor worsened compared to children who engaged in other non-swimming play activities.
  • Contacting families via SMS messages is an acceptable communication strategy to try to improve the health of their children's ears, but more needs to be done to improve access and quality of health services for ear disease.
  • The impact of each new pneumococcal vaccine is being evaluated by regular surveillance of ear health and bacterial pathogens in young children across remote regions of the Northern Territory and in Western Australia.
  • Two RCTs are evaluating the effect of combining pneumococcal vaccines at an earlier age on onset and persistence of OM and bacterial infection. In addition to antibody concentrations, the functioning of the immune response is also being evaluated.