Open Access Open Badges Research article

Longitudinal analysis of ear infection and hearing impairment: findings from 6-year prospective cohorts of Australian children

Vasoontara Yiengprugsawan1*, Anthony Hogan2 and Lyndall Strazdins1

Author Affiliations

1 The Australian National University, National Centre for Epidemiology and Population Health, Acton, Canberra, ACT 2601, Australia

2 The Australian National University, School of Sociology, Beryl Rawson Building, Acton, Canberra, ACT 2601, Australia

For all author emails, please log on.

BMC Pediatrics 2013, 13:28  doi:10.1186/1471-2431-13-28

Published: 21 February 2013



Middle ear infection is common in childhood. Despite its prevalence, there is little longitudinal evidence about the impact of ear infection, particularly its association to hearing loss. By using 6-year prospective data, we investigate the onset and impact over time of ear infection in Australian children.


We analyse 4 waves of the Longitudinal Study of Australian Children (LSAC) survey collected in 2004, 2006, 2008, and 2010. There are two age cohorts in this study (B cohort aged 0/1 to 6/7 years N=4242 and K cohort aged 4/5 to 10/11 years N=4169). Exposure was parent-reported ear infection and outcome was parent-reported hearing problems. We modelled ear infection onset and subsequent impact on hearing using multivariate logistic regressions, reporting Adjusted Odds Ratios (AOR) and Confidence Intervals (95% CI). Separate analyses were reported for indigenous and non-indigenous children.


Associations of ear infections between waves were found to be very strong both among both indigenous and non-indigenous children in the two cohorts. Reported ear infections at earlier wave were also associated with hearing problems in subsequent wave. For example, reported ear infections at age 4/5 years among the K cohort were found to be predictors of hearing problems at age 8/9 years (AOR 4.0, 95% CI 2.2-7.3 among non-indigenous children and AOR 7.7 95% CI 1.0-59.4 among indigenous children). Number of repeated ear infections during the 6-year follow-up revealed strong dose–response relationships with subsequent hearing problems among non-indigenous children (AORs ranged from 4.4 to 31.7 in the B cohort and 4.4 to 51.0 in the K cohort) but not statistically significant among indigenous children partly due to small sample.


This study revealed the longitudinal impact of ear infections on hearing problems in both indigenous and non-indigenous children. These findings highlight the need for special attention and follow-up on children with repeated ear infections.

Ear infection; Hearing impairment; Hearing loss; Longitudinal study; Australia