Stanford University School of Medicine, Stanford, California, United States of America.
Child Health Research Foundation, Dhaka, Bangladesh.
PLoS One. 2021 Apr 16;16(4):e0249824. doi: 10.1371/journal.pone.0249824. eCollection 2021.
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).
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.
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).
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.
皮肤疾病是全球导致非致命疾病的第四大主要原因，特应性皮炎（AD）是一个主要且日益严重的贡献因素。尽管特应性皮炎（AD）的患病率正在上升，但对于中低收入国家（LMICs）的儿童和家庭，人们对其社会心理影响知之甚少。
我们在孟加拉国农村地区进行了一项基于社区的横断面调查，使用国际儿童哮喘和过敏研究（ISAAC）问卷来测量 AD 的患病率和严重程度，使用患者导向的湿疹测量（POEM）来测量严重程度，以及使用婴儿湿疹生活质量指数（IDQoL）和湿疹家庭指数（DFI）来测量生活质量。
2242 名 5 岁以下儿童的总体 AD 患病率为 11.9%（95%置信区间[CI]为 10.6-13.3%）。在 30-35 个月大的儿童中，患病率最高（16.2%[95%CI为 11.4-21.0]）。IDQoL 在男性（2.67）中显著高于女性（1.95，p=0.015），在最低（3.06）和最高（1.63）财富五分位数（p<0.001）中，以及在母亲受教育程度低于（2.41）和高于（1.43）中学（p=0.039）。POEM 严重程度与 IDQoL（r=0.77，p<0.001）和 DFI（r=0.56，p<0.001）呈正相关。护理人员评定的严重疾病与 POEM（r=0.73，p<0.001）、IDQoL（r=0.82，p<0.001）和 DFI（r=0.57，p<0.001）呈正相关。
严重的 AD 显著影响孟加拉国儿童及其家庭的生活质量。随着中低收入国家医疗保健的普及，需要识别和治疗与该疾病相关的医疗和社会心理病态。
