Indigenous children experience excessive rates of otitis media. The disease is caused by many different bacteria. Previously, researchers have only been able to examine one bacterium at a time. Metagenomics is a new science which allows study of numerous bacteria simultaneously. Using metagenomic methods, we aim to understand how otitis media develops and why some children do not respond to therapy. This will allow the design of better interventions to improve ear health for Indigenous children.

Using data previously collected from other studies in Indigenous communities and children in child care, mathematical models allow us to ask "what if?", and answer important public health questions:

1. What environmental and public health measures can reduce the cycle of cross-infection in child-care and high-risk populations?
2. What coverage rates with pneumococcal vaccine will eliminate the vaccine-specific bacteria from child care centres, from the wider community, and from high risk populations?
3. Will infections with bacteria not covered by vaccine then increase?
4. Will the resistant bacteria tend to disappear if antibiotic use is restricted?
5. Under what circumstances will antibiotics help to control infection? 

The modelling approach will promote understanding of the social and health costs of bacterial infection in Aboriginal communities and child care.  We will use educational scenarios to promote uptake of the most cost-effective and socially acceptable interventions.