The Impact of Libyan Pediatric Atopic Dermatitis on Their Families

Background: Atopic dermatitis (AD) and psoriasis are common chronic skin diseases affecting children. These disorders negatively impact the quality of life (QoL) of patients in health related aspects such as physical, psychosocial, and mental functioning. This health impact is more accurately represented when accounting for the numerous co-morbidities associated with each disorder.

Aim of the Study: To assess the impact of atopic dermatitis on families of children under four years with the condition and to identify factors affecting family impact, in addition to correlate the impact with their quality of life.

Materials and Methods: A cross sectional survey conducted over period of 6 months. The study include 100 families of children aged 4 years and below, with the diagnosis of atopic dermatitis attending outpatients dermatology clinic at Benghazi medical center and AL-Kish polyclinic, Benghazi-Libya. Demographic and clinical data were collected directly using interview data collection form. Three Item Severity (TIS) score included in the study and based on oedema/ papulation, excoriation and erythema. The total score ranged from 0 to 9. To assess the impact of the children's AD on the parents' QoL, the Dermatitis Family Impact Questionnaire was used with score ranges from 0-30, higher score indicated bad quality of life. Data obtained were analyzed using SPSS version 26 at statistical significance 0.05.

Results: In this study 100 families of AD children, 50% males, age ranges from 4 to 47 months, 67% had family history of atopy, 47% suffered from other types of atopies. The mean severity index was 4.58. The FDQLI score was ranged from 0 to 26 (mean 16.64) reflecting moderate family impact. AD impact varies among families, to be moderate in 53%, severe in 31, small in 11% and normal in 5%. Ten areas where AD impact the families quality of life were evaluated. Extra expenditure, people reactions, burden of care, people reaction and emotional impact were the most factors showing the greatest impact caused by the presence of AD child in the family. A correlation between FDLQI and disease severity showed that quality of life was significantly more disturbed with increasing severity of the disease. There were no significant differences in families quality of life score regarding the gender and the age of the child, The quality of life showed a significant association with family’s educational level. Families with education beyond secondary (fathers and mothers) more severely affected.

Conclusion: AD appeared to have a moderate impact on the QoL of the enrolled families. QoL measured by FDLQI was significantly more disturbed with increasing severity of the disease. The quality of life showed a significant negative association with family’s educational level. To the best of our knowledge this is the first to be reported from Libya and North Africa.