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.
Key staff:

 

 

  1. Oguoma, V.M., Wilson, N., Mulholland, K., Santosham, M., Torzillo, P., McIntyre, P., . . . Leach, A.J. (2020). 10-Valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine (PHiD-CV10) versus 13-valent pneumococcal conjugate vaccine (PCV13) as a booster dose to broaden and strengthen protection from otitis media (PREVIX_BOOST) in Australian Aboriginal children: study protocol for a randomised controlled trial. BMJ Open, 10(5), e033511.
  2. He, V.Y., Guthridge, S., Su, J.Y., Howard, D., Stothers, K. & Leach, A.J. (2020). The link between hearing impairment and child maltreatment among Aboriginal children in the Northern Territory of Australia: is there an opportunity for a public health approach in child protection? BMC Public Health, 20(1), 449. doi:10.1186/s12889-020-8456-8.
  3. Kaspar, A. & Leach, A.J. (2020). Hearing loss among Australian Aboriginal infants and toddlers: A systematic review. Public Health in Practice, 1. doi:10.1016/j.puhip.2020.100048.
  4. Beissbarth, J., Smith-Vaughan, H.C., Harris, T.M., Binks, M.J. & Leach, A.J. (2019). Use of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) in an Australian Indigenous paediatric population does not alter the prevalence of nontypeable Haemophilus influenzae without the protein D gene. Vaccine, 37(30), 4089-4093. doi: 10.1016/j.vaccine.2019.05.079
  5. Brophy-Williams, S., Jarosz, K., Sommer, J., Leach, A.J. & Morris, P.S. (2019). Preventative and medical treatment of ear disease in remote or resource-constrained environments. J Laryngol Otol, 131(S2), 1-14. doi:10.1017/s0022215119000057. 
  6. He, V.Y., Su, J.Y., Guthridge, S., Malvaso, C., Howard, D., Williams, T. & Leach, A.J. (2019). Hearing and justice: The link between hearing impairment in early childhood and youth offending in Aboriginal children living in remote communities of the Northern Territory, Australia. Health Justice, 7(1), 16. doi:10.1186/s12889-020-8456-8.
  7. Su, J.Y., He, V.Y., Guthridge, S., Howard, D., Leach, A.J. & Silburn, S. (2019). The impact of hearing impairment on Aboriginal children's school attendance in remote Northern Territory: a data linkage study. Aust N Z J Public Health, 43(6), 544-550. doi: 10.1111/1753-6405.12948.
  8. Wigger, C., Leach, A.J., Beissbarth, J., Oguoma, V., Lennox, R., Nelson, S., . . . Morris, P. (2019). Povidone-iodine ear wash and oral cotrimoxazole for chronic suppurative otitis media in Australian aboriginal children: study protocol for factorial design randomised controlled trial. BMC Pharmacol Toxicol, 20(1), 46. doi:10.1371/journal.pone.0215483.
  9. Jervis-Bardy, J., Carney, A.S., Duguid, R. & Leach, A.J. (2017). Microbiology of otitis media in Indigenous Australian children: review. J Laryngol Otol, 131(S2), S2-S11. doi:10.1017/s0022215116009294.
  10. Jervis-Bardy, J., Leong, L.E., Marri, S., Smith, R.J., Choo, J.M., Smith-Vaughan, H.C., . . . Marsh, R.L. (2015). Deriving accurate microbiota profiles from human samples with low bacterial content through post-sequencing processing of Illumina MiSeq data. Microbiome, 3, 19. doi:10.1186/s40168-015-0083-8.
  11. Leach, A.J. Wigger, C., Beissbarth, J., Woltring, D., Andrews, R., Chatfield, M.D., Smith-Vaughan, H. & Morris, P.S. (2016). General health, otitis media, nasopharyngeal carriage and middle ear microbiology in Northern Territory Aboriginal children vaccinated during consecutive periods of 10-valent or 13-valent pneumococcal conjugate vaccines. Int J Pediatr Otorhinolaryngol, 86, 224-232. doi:10.1016/j.ijporl.2016.05.011
  12. Nicholls, T.R., Leach, A.J & Morris, P.S. (2016). The short-term impact of each primary dose of pneumococcal conjugate vaccine on nasopharyngeal carriage: Systematic review and meta-analyses of randomised controlled trials. Vaccine, 34(6), 703-713. doi:10.1016/j.vaccine.2015.12.048.
  13. Smith-Vaughan, H.C., Beissbarth, J., Bowman, J., Hare, K.M., Price, E.P., Pickering, J., Lehmann, D., Chang, A.B., Morris, P.S., Marsh, R.L. & Leach, A.J. (2016). Geographic consistency in dominant, non-typeable Haemophilus influenzae genotypes colonising four distinct Australian paediatric groups: a cohort study. Pneumonia (Nathan), 8, 13. doi: 10.1186/s41479-016-0013-y.
  14. Jervis-Bardy, J.R., Rogers, G.B., Morris, P. S., Smith-Vaughan, H. C., Nosworthy, E., Leong, L.E., Smith, R.J., Weyrich, L.S., De Haan, J., Carney, A.S., Leach, A.J., O'Leary, S. & Marsh, R.L. (2015). The microbiome of otitis media with effusion in Indigenous Australian children. Int J Pediatr Otorhinolaryngol, 79(9), 1548-1555. doi:10.1016/j.ijporl.2015.07.013.
  15. Leach, A. ., Wigger, C., Hare, K., Hampton, V., Beissbarth, J., Andrews, R., Chatfield, M., Smith-Vaughan, H.C. & Morris, P.S. (2015). Reduced middle ear infection with non-typeable Haemophilus influenzae, but not Streptococcus pneumoniae, after transition to 10-valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine. BMC Pediatr, 15, 162. doi:10.1186/s12887-015-0483-8.
  16. Leach, A.J., Wigger, C., Andrews, R., Chatfield, M., Smith-Vaughan, H.C. & Morris, P.S. (2014). Otitis media in children vaccinated during consecutive 7-valent or 10-valent pneumococcal conjugate vaccination schedules. BMC Pediatr, 14, 200. doi:10.1186/1471-2431-14-200.
  17. Phillips, J.H., Wigger, C., Beissbarth, J., McCallum, G.B., Leach, A. & Morris, P.S. (2014). Can mobile phone multimedia messages and text messages improve clinic attendance for Aboriginal children with chronic otitis media? A randomised controlled trial. J Paediatr Child Health, 50(5), 362-367. doi:10.1111/jpc.12496.
  18. Smith-Vaughan, H.C., Binks, M.J., Marsh, R.L., Kaestli, M., Ward, L., Hare, K.M., . . . Leach, A.J. (2013). Dominance of Haemophilus influenzae in ear discharge from Indigenous Australian children with acute otitis media with tympanic membrane perforation. BMC Ear Nose Throat Disord, 13(1), 12. doi:10.1186/1472-6815-13-12.
Click here to view more ear publications in PubMed.
  1. Hopes AI program can treat Indigenous hearing loss in remote areas

    Hopes AI program can treat Indigenous hearing loss in remote areas

    Date

    Professor Amanda Leach, who runs the ear health research program at Menzies School of Health Research in Darwin, said the illness was common in remote Indigenous communities across the Northern Territory.

  2. New interactive guidelines for healthy ears

    New interactive guidelines for healthy ears

    Date

    I-CHEAR director and Menzies School of Health Research senior principal research fellow, Professor Amanda Leach AM said that the updated guidelines are needed to improve delivery and access to quality ear health care across Australia.

  3. New multi-platform interactive guidelines for healthy ears

    New multi-platform interactive guidelines for healthy ears

    Date

    The Otitis Media guidelines have been launched today to assist healthcare workers provide comprehensive and appropriate care for Aboriginal and Torres Strait Islander children with otitis media and hearing problems.

  4. Ear disease in Aboriginal and Torres Strait Islander children

    Ear disease in Aboriginal and Torres Strait Islander children

    Date

    In remote communities across the Northern Territory (NT), only one in 10 Aboriginal children younger than three years have healthy ears, a new report in the Medical Journal of Australia (MJA) has found.

  5. University of Newcastle | Aboriginal ear surgeon honoured with Menzies Medallion

    University of Newcastle | Aboriginal ear surgeon honoured with Menzies Medallion

    Date

    Associate Professor Kelvin Kong received the medal on Friday, recognising his leadership in Aboriginal health service delivery, advocacy and research.

  6. Aboriginal ear surgeon honoured with Menzies Medallion

    Aboriginal ear surgeon honoured with Menzies Medallion

    Date

    Australia’s first Aboriginal surgeon, the highly acclaimed ear, nose and throat surgeon, Associate Professor Kelvin Kong has been awarded the prestigious Menzies Medallion.

  7. NT News | Graduates a boost for ear health

    NT News | Graduates a boost for ear health

    Date

    A group of Tiwi Islanders are working to improve ear health in their communities after becoming the first graduates of a new ear infection prevention program.

  8. Hearing loss impacts school attendance among Australia's aboriginal children

    Hearing loss impacts school attendance among Australia's aboriginal children

    Date

    The study was led by Dr. Jiunn-Yih Su with the Centre for Child Development and Education, Menzies School of Health Research, and the Charles Darwin University.

  9. Hearing loss linked to poor school attendance in the Northern Territory

    Hearing loss linked to poor school attendance in the Northern Territory

    Date

    Study investigating the impact of hearing impairment on school attendance for children published in the Australian and New Zealand Journal of Public Health.

  10. Severe specialist shortage leaves Aboriginal children at risk of hearing loss

    Severe specialist shortage leaves Aboriginal children at risk of hearing loss

    Date

    Menzies School of Health Research professor Amanda Leach has been working in hearing health in the NT and said Aboriginal communities were becoming frustrated with service delivery.

  11. Indigenous issues top to-do list as super-rich urged to dig deep

    Indigenous issues top to-do list as super-rich urged to dig deep

    Date

    Supports for a five-year project at the Menzies School of Health Research to address hearing problems among indigenous people in the Northern Territory.

  12. NT News | Big Night for Territorians

    NT News | Big Night for Territorians

    Date

    Report on Professor Amanda Leach and other NT finalists in the 2019 Telstra Businesswomen's Awards .

  13. Menzies researchers’ finalists in the 2019 Telstra Business Women’s Awards

    Menzies researchers’ finalists in the 2019 Telstra Business Women’s Awards

    Date

    Two researchers from Menzies School of Health Research (Menzies) have been named finalists in the 2019 Telstra Business Women’s Awards.

  14. NT News | Our children's hearing crisis

    NT News | Our children's hearing crisis

    Date

    To address chronic hearing problems in the NT's most vulnerable children a $7.9 million community-led program will be rolled out.

  15. New program to tackle ear infection crisis

    New program to tackle ear infection crisis

    Date

    The five-year Hearing for Learning program is based on research by scientists at the Menzies School of Health Research and will employ and train community residents to help spot and treat ear disease and hearing problems.

  16. Large donation for vital research

    Large donation for vital research

    Date

    The generous staff at Darwin Airport have donated $13,000 to Menzies School of Health Research to go towards the purchase of Anaerobic Chamber.

  17. Anaerobic Chamber to help improve lives of Indigenous Children.

    Anaerobic Chamber to help improve lives of Indigenous Children.

    Date

    The Chamber is a crucial piece of equipment for growing anaerobic bacteria that can be found in children under the age of 5 with middle ear infections and chronic lung disease.

  18. The Australian | Silence is golden but not when it’s permanent

    The Australian | Silence is golden but not when it’s permanent

    Date

    Meanwhile, in the Northern Territory, dozens of project officers in 20 communities will complement the work of visiting ear specialists under a $7.9m partnership between the commonwealth, the Northern Territory government and the Balnaves Foundation, supported by the Menzies School of Health Research.

  19. Lend me your ear: New program targets hearing problems in NT children

    Lend me your ear: New program targets hearing problems in NT children

    Date

    RACGP report on the Hearing for Learning Initiative.

  20. Hearing loss a serious issue

    Hearing loss a serious issue

    Date

    Announced in August, Hearing for Learning is a five year program of the NT Government, founded on research by scientists at the Darwin-based Menzies School of Health Research.

  21. F&P| Balnaves Foundation contributes $2.5m to treating Indigenous hearing loss

    F&P| Balnaves Foundation contributes $2.5m to treating Indigenous hearing loss

    Date

    New initiative is jointly funded by the NT and federal governments, based on research from the Menzies School of Health Research.

  22. Daily Mail | How 90 PER CENT of Aboriginal children are born with ear disease and most will end up half-deaf with brain development problems

    Daily Mail | How 90 PER CENT of Aboriginal children are born with ear disease and most will end up half-deaf with brain development problems

    Date

    A shocking 90 per cent of Aboriginal children in remote Northern Territory communities under three years old are born with an ear disease that can lead to significant development problems.

  23. ABC | 'Glue ear' project to fight hearing loss and improve outcomes for Aboriginal children

    ABC | 'Glue ear' project to fight hearing loss and improve outcomes for Aboriginal children

    Date

    Up to nine in every 10 Aboriginal children in some remote Northern Territory communities have a hearing impairment, but a new project aims to tackle that by training locals and reducing fly-in-fly-out (FIFO) specialists.

  24. Sounds Like Progress | NT News 15 August 2018

    Sounds Like Progress | NT News 15 August 2018

    Date

    $7.9 million investment in remote NT - Hearing for Learning Initiative

  25. Ear Health Funding

    Ear Health Funding

    Date

    Coverage of the Hearing for Learning Initiative Launch with the Northern Territory Government and the Balnaves Foundation on ABC TV News.

  26. Investing in Territory Kids and Generational Change – Hearing for Learning

    Investing in Territory Kids and Generational Change – Hearing for Learning

    Date

    A public private partnership between the Northern Territory Government, Australian Government and the Balnaves Foundation is addressing chronic hearing problems in Territory children.

  27. NT News 14 August 2018 OMOZ 2018 coverage and editorial

    NT News 14 August 2018 OMOZ 2018 coverage and editorial

    Date

    5th Australian Otitis media Conference underway in Darwin.

  28. ABC TV Back Roads program features Christine Wigger

    ABC TV Back Roads program features Christine Wigger

    Date

    Christine Wigger has been researching otitis media in the Tiwi Islands over 15 years.

  29. Vaccination improves education outcomes

    Vaccination improves education outcomes

    Date

    High rates of perforated eardrums and hearing loss in Indigenous children living in remote communities has been linked to poor school attendance, social and behavioural problems, as well as exclusion from employment later in life. Otitis media is caused...

  30. Indigenous ear health the "missing piece of the disadvantage puzzle"

    Date

    RN Life Matters - In many Indigenous communities, middle ear infections are rife, leading to hearing problems and a life of disadvantage.

  31. I HEAR BETA study improves hearing outcomes

    I HEAR BETA study improves hearing outcomes

    Date

    Improving hearing outcomes through I HEAR BETA study Indigenous children living in remote areas of the NT are prone to a severe middle ear disease known as chronic suppurative otitis media (CSOM), or runny ears. Although disease rates have decreased over...

  32. Australian Doctor - otitis media clinical trial

    Australian Doctor - otitis media clinical trial

    Date

    Otitis Media - a clinical trial where Indigenous infants will receive an extra dose of pneumococcal vaccine to try and cut down the rates of incidence.

  33. New treatment trialled in battle against ear disease

    New treatment trialled in battle against ear disease

    Date

    In a world first, Northern Territory researchers are trialling a new treatment to heal an ear disease plaguing Indigenous communities and causing lifelong disadvantage.

  34. Menzies secures 2016 NHMRC funding for groundbreaking projects

    Menzies secures 2016 NHMRC funding for groundbreaking projects

    Date

    Innovation and transformation are at the heart of the Menzies School of Health Research (Menzies) projects which have secured funding in the highly competitive NHMRC grant round.

  35. Bulging ear drums and hearing loss: Aboriginal kids have the highest otitis media rates in the world

    Bulging ear drums and hearing loss: Aboriginal kids have the highest otitis media rates in the world

    Date

    This article is the final in our three-part series on blinding, deafening and sometimes deadly conditions in Indigenous Australian children that have little to no impact on their non-Indigenous counterparts.

  36. Support call over children's ear health

    Support call over children's ear health

    Date

    LEADING ear health experts at Menzies School of Health Research (Menzies) are calling for more investment in the prevention and treatment of ear disease and hearing loss among Indigenous children.

  37. What is the relationship between lifelong hearing loss and Indigenous incarceration? A powerful story to mark Hearing Awareness Week

    What is the relationship between lifelong hearing loss and Indigenous incarceration? A powerful story to mark Hearing Awareness Week

    Date

    What profound impact could be had on high rates of Aboriginal and Torres Strait Islander incarceration by ensuring better hearing for children and adults? It’s an important question raised in this moving post below, to mark Hearing Awareness Week, from Sam Harkus, Principal Audiologist, Aboriginal & Torres Strait Islander Services.

  38. Call to prevent hearing loss and improve school readiness in young children

    Date

    In recognition of Hearing Awareness Week (August 21-27), leading ear health experts at Menzies School of Health Research (Menzies) are calling for more investment in the prevention and treatment of ear disease and hearing loss in Aboriginal and Torres Strait Islander children.

  39. Menzies ear and hearing health program wins $2.5 million in ‘research excellence’ funding

    Menzies ear and hearing health program wins $2.5 million in ‘research excellence’ funding

    Date

    A leading ear and hearing health collaborative research program led by Menzies was today declared a ‘Centre of Research Excellence (CRE)’ and awarded funding of $2.5 million over five years.

  40. Medical Journal of Australia: Impact of swimming on chronic suppurative otitis media in Aboriginal children

    Medical Journal of Australia: Impact of swimming on chronic suppurative otitis media in Aboriginal children

    Date

    Impact of swimming on chronic suppurative otitis media in Aboriginal children: a randomised controlled trial.

  41. Swimming pools: neither friend nor foe for Aboriginal children with severe ear disease

    Swimming pools: neither friend nor foe for Aboriginal children with severe ear disease

    Date

    Research by Menzies has found that swimming pools are unlikely to significantly reduce or increase levels of severe middle ear disease in remote Aboriginal communities.

  42. ABC Darwin: Menzies launches giant ear

    ABC Darwin: Menzies launches giant ear

    Date

    Aboriginal health worker Joe Daby has seen the worst when it comes to ear health in Territory communities.

  43. Health to shine at Close The Gap Day Charity Breakfast

    Health to shine at Close The Gap Day Charity Breakfast

    Date

    An opportunity to hear from leading Indigenous health experts about inventive new ways they are closing the gap is set to draw some of the Territory’s most influential and iconic identities for a formal charity breakfast.

  44. Ear disease affecting Territory children

    Ear disease affecting Territory children

    Date