Affiliation:
1. Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University , Alexandria , Egypt
2. Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London , London , UK
3. The Royal London Hospital, Barts Health NHS Trust , London , UK
Abstract
Abstract
Background
Atopic eczema (AE) is a chronic relapsing, pruritic disease that greatly affects the child and family’s quality of life (QoL). It is usually common and severe among children of Bangladeshi ethnicity.
Objectives
This is a cross-sectional quantitative study in patients with AE of Bangladeshi origin, which aims to analyse different components of the family, children and adult quality-of-life indices and their relationship to patient age, sex, eczema severity and distribution, other allergic associations, parental education and socioeconomic level.
Methods
Children and young adults of Bangladeshi origin aged 0–30 years, clinically diagnosed with AE were recruited as part of the Tower Hamlets Eczema Assessment project, a clinical phenotyping study of AE in the Bangladeshi population living in East London. Questionnaires completed by children/parents included the Family Dermatology Life Quality Index (FDLQI), Infant’s Dermatology Quality of Life (IDQOL) and the Children’s Dermatology Life Quality Index (CDLQI). Young adults completed the Dermatology Life Quality Index (DLQI). The disease severity was assessed objectively using the Eczema Area Severity Index (EASI). Patients and parents who did not read or speak English were aided by Bengali/Sylheti-speaking research assistants.
Results
Overall, 460 Bangladeshi children and 98 adults with AE were recruited. Burden of care, extra housework and emotional distress were the highest affected domains in parental QoL, while itching and sleep were the highest for children. Significant factors influencing FDLQI score were EASI [marginal effect (ME) 1.01, 95% confidence interval (CI) 1.00–1.03; P = 0.004], age (ME 0.98, 95% CI 0.97–0.99; P = 0.004), extensor eczema distribution (ME 1.25, 95% CI 1.03–1.52; P = 0.023), parental English fluency (ME 1.29, 95% CI 1.10–1.52; P = 0.002) and atopic comorbidities (ME 1.10, 95% CI 1.04–1.17; P = 0.001). Parental socioeconomic class was a nonsignificant factor. IDQOL/CDLQI was influenced significantly by the child’s age (ME 0.99, 95% CI 0.97–1.00, P = 0.023), ‘nonclear’ eczema distribution clusters especially the ‘severe extensive’ cluster (ME 1.46, 95% CI 1.15–1.84; P = 0.002) and nonsignificantly by EASI and parental English literacy and socioeconomic levels. DLQI was affected significantly by nonclear eczema distribution groups especially ‘severe extensive’ (ME 2.49, 95% 1.76–3.53; P < 0.001) and nonsignificantly by patient age, and female sex.
Conclusions
AE is a chronic disease where many external factors other than disease severity affect QoL of patients and their families, especially in under-represented minority groups who face different linguistic and cultural barriers.
Publisher
Oxford University Press (OUP)
Cited by
1 articles.
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