Otitis media cases in China require more attention

A recent systematic review and meta-analysis reveals a considerable burden of otitis media (OM) in China that is often overlooked. At present, the most common bacterial pathogen identified is Streptococcus pneumoniae (S pneumoniae).

A team of investigators identified studies published from 1980 to 2022 using the databases of PubMed, Ovid-Embase, Web of Science, CNKI, Wanfang, and VIP. Two independent reviewers carried out the literature screening, quality assessment, and data extraction.

The investigators used I², Egger’s, and Begg’s tests to detect heterogeneity and publication bias. They pooled data using the random-effects model and estimated the number of OM cases using the multiplied model based on pooled results and the 2020 China census data.

Of the 28,378 studies identified, 67 met the eligibility criteria for the final analysis. The incidence of OM among children stood at 7.89 percent (95 percent confidence interval [CI], 5.43‒11.33), while its prevalence was 5.13 percent (95 percent CI, 3.49‒7.49).

Among OM cases, the most frequently identified pathogen was S pneumoniae (positive rate, 33.52 percent, 95 percent CI, 26.55‒41.29), and the commonly isolated serotypes were 19F, 19A, 6B, 23F, and 3, with 85.8 percent covered by the PCV13.

Based on estimates, there appeared to be 8,950,797 (95 percent CI, 6,080,533–12,928,051) OM cases among children <5 years of age in China as of 2020. Of these cases, 3,374,451 (95 percent CI, 1,698,901–6,277,862) were caused by S pneumoniae.

“Vaccination may be effective to protect young children from OM,” the investigators said.