Assessment of the quality of life, treatment practices, and associated factors among children with atopic dermatitis patients at All Africa Leprosy, TB and rehabilitation training center (A.L.E.R.T), Addis Ababa, Ethiopia: A prospective observational study
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Date
2023
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Addis Ababa University
Abstract
Background: Atopic dermatitis (AD) is the most common chronic skin disease in children. It is
chrcaterized by dry, itchy, eczematous skin symptoms. These symptoms produce dramatic negative
impact on quality of life (QoL) of patients.There is a paucity of study on patients’ QoL, the pattern
of treatment practices, and factors associated with poor QoL in children with AD in Ethiopia.
Objective: To assess QoL, treatment practice, symptoms control status and its associated factors
among children with AD at ALERT dermatovenerology unit, Addis Ababa, Ethiopia.
Method: Prospective observational study was conducted at ALERT comprehensive specialized
hospital dermatovenereology unit from September 01, 2022 to February 31, 2023. Structured
questionnaire and CDLQI tool were used to collect the data. Data were collected, entered and
analyzed using Statistical Package for the Social Sciences (SPSS®) version 25. Descriptive
statistics were used to summarize the data while multivariable binary logistic regression analysis
was used to determine factors associated with QoL. P-value <0.05 was considered as statistically
significant.
Results: Among 403 study partciapnst (53.6% , n= 216 ) were female. The mean (+SD) age of the
study participants was 8.04 (+3.40) years. The age onset of the disease in (41.7 %, n= 168) study
participants was mid onset. Among study participants, the majority of them, (84.6%, n= 341) had
pure AD.The duration of the disease in (76.4 %, n= 308) patients were less than to 5 years. Among
study participants, the majority of them, (42.2 %, n= 170) had Sub- Acute phase, Non lessional
type AD (71.7 %, n= 289), followed by Moderate (57.6 %, n= 232). Topically applied readymade
medicine, antihistamine and emollient was given for (55.6 %, n = 224), (24.3 %, n= 98) and
(75.8%, n=305) partcipants, respectively. The mean CDLQI was 8.42(+ 3.57) crosponding to a
moderate effect. Domain of itching, dressing and sleeping was the utmost affected QoL. Majority
of the study partcipants (75.7%, n=305) had localized Pruritus followed by , dry skin (70.7%, n=
285) symptoms .AD symptoms was controlled among (76.9%, n = 310) patients. Multivariabel
logistic regression showed that government employed caregivers [AOR=5.5 (95% CI: [1.18,
27.61)], P=0.038; daily laborer caregivers [AOR = 16.23 (95 % CI: [1.78, 148.1)], P= 0.014
,having moderate AD [AOR = 4.20 (95% CI: [2.25, 7.8)], P=0.001), having Allergic rhinitis
comorbidities [AOR=20.6 (95% CI: [1.55,275.5)], P=0.022 and who use topically applied
Tacrolimus [AOR=5.63 (CI: 1.03, 30.92)] was signifcantly associated with QoL.
IV
Conclusion: Emollients, topically corticosteroids, and antihistamines were the mainstay
treatment. AD has significant impact on the QoL of children, mainly through Symptom and
feeling , sleeping problems and dressing problems. Majority of children with AD symptoms were
controlled. Factors such as Government employee, daily laborer, moderate AD , allergic rhinitis,
and use of topical tacrolimus were considered to have poor QoL. Thus, widening the AD
management with education and evaluating of children QoL deemed to be imprortant.
Description
Keywords
Atopic dermatitis (AD), Quality of Life (QoL), Child Dermatology Life Quality Index (CDLQI), All Africa Leprosy, TB, and rehabilitation training Center (ALERT), Ethiopia.