Global patterns and demographic drivers of hearing loss attributable to otitis media, 1990–2023

BACKGROUND: Otitis media is a common childhood condition and a leading cause of preventable hearing loss worldwide. Although global hearing loss has been widely studied, recent and comparable estimates focusing specifically on hearing loss attributable to otitis media across age, sex, development level, and countries remain limited. Updated assessments are needed to characterise long-term patterns and demographic drivers. METHODS: We analysed Global Burden of Disease 2023 estimates at the global level, across four Socio-demographic Index (SDI) groups, and among selected countries with available country-level estimates from 1990 to 2023. Age-standardised, age-specific, and sex-specific estimates were examined. Temporal trends were assessed using annual percentage change (APC) derived from log-linear regression models. A stepwise decomposition analysis quantified the contributions of population growth, population ageing, and changes in age-specific YLD rates to overall YLD change. All analyses were conducted using R version 4.3.2. RESULTS: Globally, age-standardised prevalence declined modestly between 1990 and 2023, with consistently higher levels observed in low and low-middle SDI settings. In 2023, prevalence peaked among children aged 5-14 years and declined steadily with increasing age, reaching the lowest levels among adults aged ≥70 years. Males had higher prevalence than females across most settings. Mild hearing loss accounted for nearly four-fifths of the global age-standardised burden, consistent with the severity structure of otitis media-attributable hearing loss in the Global Burden of Disease framework. No country showed a statistically significant increase in APC; most exhibited stable or declining trends, with faster decreases observed in several middle- and high-middle SDI countries. Decomposition analysis indicated that population growth was the primary contributor to increasing global YLDs, while declines in age-specific YLD rates partially offset demographic pressures in many regions. CONCLUSIONS: Hearing loss attributable to otitis media remains an unevenly distributed global health burden, particularly among school-aged children and populations in lower-SDI settings. These findings describe long-term trends and demographic drivers relevant to planning prevention and ear and hearing care services.