Impact of atopic dermatitis on the quality of life of Nigerian children: A hospital-based cross-sectional study

Abstract

Background. Atopic dermatitis (AD) is the most common inflammatory skin disease in childhood. A skin disorder with a relapsing course, AD exerts a significant disease burden on affected children. However, there is a dearth of knowledge about the impact of AD on the quality of life (QOL) of affected children in Nigeria. Objectives. To examine the impact of AD on QOL in children of various age groups, and to identify the relationship between patient variables (age, gender, socioeconomic status), disease severity and QOL in AD. Method. This was a cross-sectional descriptive study of children with AD attending the dermatology clinic of Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria. AD cases were recruited from new paediatric patients ≤16 years who attended the clinic over a 6-month period. English and Yoruba versions of the Infants' Dermatitis Quality of Life Index (IDQOL) and the Children's Dermatology Life Quality Index (CDLQI) were used to determine the QOL of the subjects. AD severity was evaluated using the Objective SCORing of Atopic Dermatitis (obj-SCORAD) index. Results. Forty-seven subjects with AD were identified. Their ages ranged from newborn to 16 years. The median(interquartile range (IQR)) IDQOL score was 6.0 (3.0 -15.5; n=25), and the median (IQR) CDLQI score was 9.5 (7.75 -17.75; n=22). The mean (standard deviation) obj-SCORAD score was 34.4 (17.2). The question on itching was the highest-scoring question in both QOL questionnaires. There was no significant difference in QOL across age, gender and socioeconomic status groups. However, greater QOL scores were significantly correlated with higher AD severity scores. Conclusion.The study confirms that AD impairs the QOL of affected children in all age groups. QOL assessments are relevant tools which provide a patient's perspective, thus improving the understanding of the impact of AD on afflicted individuals.

Atopic dermatitis in children: a cross-sectional study of its impact on quality of life

“…This is similar to the conclusions drawn from other studies, however Durovic et al showed that children with AD between the age of 5-9 years had most impaired QoL. 5,2,22 The impairment of QoL was not found to be gender specific in the current study, although some authors have reported gender differences in the impact of AD in QoL of children. 7,23,24 Although the QoL scores were found to be higher in the upper lower class compared to all other socio-economic classes and among children with early onset disease.…”

“…6,16,18,19 The occurrence of pruritus as a major contributor to the magnitude of the QoL scores, also displayed a similar trend in comparison to the existing literature. 2,5,20 In addition to this, the sleep latency and quality of sleep also contributed heavily to the QoL scores, which might be secondary to the occurrence of night pruritus. Numerous authors have made similar observations about the impact of sleep disturbances.…”

“…1 It may be associated with respiratory allergies such as asthma or allergic rhinitis, together known as the atopic triad. 2 The aetiopathogenesis of AD is complex with genetics, skin barrier function, immunity, and environmental factors interacting synergistically with each other to cause and aggravate the disease. 3 AD occurs most commonly in infants and prevalence decreases with increasing age.…”

“…3 AD occurs most commonly in infants and prevalence decreases with increasing age. 2 Onset is most common between 3 and 6 months of age with approximately 60% of patients developing eruption in the first year of life and 90% by 5 years of age. While majority of affected individuals have resolution of disease by adulthood, 10% to 30% continue to remain symptomatic and a smaller percentage develop new onset symptoms during adulthood.…”

Factors Associated with Atopic Dermatitis among Children Aged 6 To 14 Years in Alimosho Local Government, Lagos, Nigeria

“…The diagnosis of atopic dermatitis is made using the Hanifin and Rajka criteria. This requires that the individual presents with a pruritic rash and three or more of the following features: history of rash in the skin creases (fold of the elbow, behind the knees, front of the ankles and around the neck), a personal or family history of asthma and hay fever, history of generalized dry skin (xerosis), onset before the age of 2 years and visible flexural dermatitis [22]. In 2004 Nnoruka, noted that the symptoms these children present with varies according to ethnicity [23].…”