Prevalence and psychosocial impact of atopic dermatitis in Bangladeshi children and families

PLoS One. 2021 Apr 16;16(4):e0249824. doi: 10.1371/journal.pone.0249824. eCollection 2021.

Abstract

Background: Skin conditions are the fourth leading cause of nonfatal disease globally, with atopic dermatitis (AD) a major and rising contributor. Though atopic dermatitis (AD) is rising in prevalence, little is known about its psychosocial effects on children and families in low- and middle-income countries (LMICs).

Methods: We conducted a community-based, cross-sectional survey of 2242 under-5 children in rural Bangladesh using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire to measure AD prevalence and severity, the Patient-Oriented Eczema Measure (POEM) to measure severity, and the Infants' Dermatitis Quality of Life index (IDQoL) and Dermatitis Family Index (DFI) to measure quality of life.

Findings: Overall AD prevalence in under-five children was 11.9% [95% confidence interval (CI) 10.6-13.3%]. Prevalence was highest in children age 30-35 months [16.2% (95% CI 11.4-21.0)]. IDQoL was significantly higher in males (2.67) vs. females (1.95, p = 0.015), the lowest (3.06) vs. highest (1.63) wealth quintile (p<0.001), and among mothers with < primary (2.41) vs. > secondary (1.43) education (p = 0.039). POEM severity was correlated with IDQoL (r = 0.77, p<0.001) and DFI (r = 0.56, p<0.001). Severe disease as rated by caretakers was correlated with POEM (r = 0.73, p<0.001), IDQoL (r = 0.82, p<0.001) and DFI (r = 0.57, p<0.001).

Conclusions: Severe AD significantly affects quality of life for children and families in Bangladesh. As access to healthcare expands in LMICs, identification and treatment of both the medical and psychosocial morbidities associated with the disease are needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bangladesh
  • Child, Preschool
  • Dermatitis, Atopic / epidemiology
  • Dermatitis, Atopic / psychology*
  • Family / psychology
  • Humans
  • Infant
  • Prevalence
  • Psychosocial Functioning*
  • Quality of Life*
  • Rural Population / statistics & numerical data

Grants and funding

Dr. Pedersen received a Medical Scholars grant from the Stanford University School of Medicine and a Benjamin H. Kean Travel Fellowship from the American Society of Tropical Medicine and Hygiene. The REDCap platform services are made possible by the Stanford University School of Medicine Research Office and are subsidized by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health. The data content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.