AUTHOR=Kelbore Abraham Getachew , Enbiale Wendemagegn , van Wyk Jacqueline M. , Mosam Anisa 

TITLE=Atopic dermatitis in Ethiopian children: a multicenter study of clinical severity, characteristics, and sociodemographic factors

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1410310

DOI=10.3389/fmed.2024.1410310

ISSN=2296-858X

ABSTRACT=Background: Atopic dermatitis (AD) is a chronic relapsing, pruritic, inflammatory skin disease. Assessing the characteristics and risk factors of severe AD is central to healthcare worker understanding and subsequent education of patients. AD has been well documented in the global north in mainly Caucasian populations whilst very few studies have been conducted in African patients residing in Africa. This study assessed the clinical characteristics and associated factors of severe AD among children in Ethiopia. 

Methods: A hospital based cross-sectional study was conducted among 461 children and their caregivers in four randomly selected hospitals in Southern Ethiopia from October 2022 to September 2023. A systematic sampling technique was used to enrol study participants. Clinical profile and sociodemographic data were collected by trained data collectors. The SCORAD index tool was used. The descriptive analysis was done to characterize study participants. Univariate and ordinary logistic regression was used to identify factors associated with SCORAD index score. The OR with 95% was used to show the strength of association and P value <0.05 was used to declare the level significance. 

Result: Out of 461 AD diagnosed children, 212(46%) were females and 249(54%) were males. In the sample of the paediatric patients, 149(32.3%) exhibited mild AD, 231(46.2%) presented with moderate, and 99(21.5%) showed sign and symptoms of severe AD. All patients had itching. Dryness of skin, excoriation, erythema followed by lichenification was the most observed signs. In ordinary logistic regression model, age onset of the disease(AOR 95% CI 1.95(1.3-2.94)), gender of caregiver or family(AOR 95% CI 0.61(0.41-0.90)), family atopy history(AOR 95% CI 0.64(0.44-0.93)), mother education status(95% CI 2.45(1.1-5.47)) and use of herbal medication(AOR 95% CI 0.50(0.33-0.79)) were significantly associated with the severity of AD.

Conclusion: In this study, sixty-eight per cent of children were found to have moderate to severe AD. Early-onset, maternal education, familial atopy history, gender of caregiver, and use of herbal medication were independent predictors of severe AD in children. We recommend further investigation into these variables for their potential to serve as markers to assess the severity of AD, improve the care and management of AD children in Ethiopia.