Assessment of quality of life, treatment practices, and associated factors among children of atopic dermatitis patients at all Africa leprosy, TB and rehabilitation training center (A.L.E.R.T): a prospective observational study.

Abstract

Background: Atopic dermatitis (AD) is the most common chronic skin disease in children. It adversely affects child's physical health, daily functioning, and overall quality of life (QoL), impacting not only the child but also their families. There is a paucity of data in Ethiopia about treatment practices and QoL among children with AD. Thus, this study aimed to assess QoL, treatment practice, AD symptom control statues and associated factors for QoL among children with AD at ALERT dermatovenerology unit, Addis Ababa, Ethiopia.

Method: Prospective observational study was employed on 403 patients. Structured questionnaire and Child Dermatology Life Quality Index (CDLQI) tool were used to collect the data. Descriptive statistics and multivariable logistic regression model were used to analyze the data.

Results: The mean (± SD) age of participants was 8.04 (± 3.40) years. Topically applied readymade medicine, antihistamine and emollient were given for (55.6%, n = 224), (24.3%, n = 98) and (75.8%, n = 305) participants, respectively. The mean (± SD) QoL was 8.42(± 3.57) indicating moderate effect. Domain of itching, dressing and sleeping was the utmost affected QoL. Three-fourths (76.9%, n = 310) of patients had their AD symptoms controlled. Caregivers who were government employees [AOR = 4.9, 95% CI: 1.22, 19.71, P = 0.02], daily labourer caregivers [AOR = 7.3, 95% CI: 1.15, 45.7, P = 0.03] and, those with moderate AD [AOR = 2.8, 95 % CI: 1.59, 4.96, P = <0.001] were significantly associated with QoL, as well as caregivers with very low (≤ 860) [AOR = 0.09, 95% CI: 0.01, 0.68, P = 0.02], low (861-1500) monthly income [AOR = 0.20, 95% CI: 0.05, 0.90, P = 0.03].

Conclusion: Patients with AD had a moderate QoL based on their CDLQL score. Three-fourths of the study participants who experienced AD-related symptoms had them controlled after 4 weeks of treatment. Among the CDLQI domains, itching and scratching, dressing problems and sleeping problems were the most affected. Caregiver employment status, monthly income, moderate type of AD and facial involvement were significantly associated with QoL outcomes.