The Impact of Atopic Dermatitis on Caregivers' Quality of Life in Ethiopia

Abraham Getachew Kelbore ^1,2* Wendemageggn Enbiale ^3,4 Jacqueline Marina Van Wyk ^5,6 Anisa Mosam ^2,7

• ¹ Department, of Dermatology, College of Health Sciences and School of Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
• ² Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa, Durban, South Africa
• ³ Department of Dermatology, College of Health Sciences and Medicine, Bahir Dar University, Bahir Dar, Ethiopia, Bahir Dar, Amhara Region, Ethiopia
• ⁴ Collaborative Research and Training Center for Neglected Tropical Diseases, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
• ⁵ Department of Clinical and Professional Practice, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa, Durban, South Africa
• ⁶ Department of Health Sciences Education, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa
• ⁷ Inkosi Albert Luthuli Central Hospital (IALCH), Durban, KwaZulu-Natal, South Africa

Abstract Background: Atopic Dermatitis (AD) significantly impacts both the physical and psychological well-being of children and caregivers. As AD severity increases, so does its negative effect on the family’s emotional, social, and economic quality. However, the psychosocial and financial challenges faced by caregivers, are often underreported, particularly in developing countries.Objectives: The study aimed to assess the impact of AD on the quality of life (QoL) of caregivers of children with AD in central and southern Ethiopia. Methods: A hospital-based cross sectional study was conducted among 461 caregivers of children with AD, from four randomly selected hospitals in Central and Southern Ethiopia between October 2022 and December 2023. A systematic sampling technique was used to enrol study participant Sociodemographic and clinical data were collected by trained nurses. The Dermatitis Family Impact (DFI) questionnaire to assess QoL and the SCORAD index to measure the severity of the diseases. Descriptive statistics, Spearman rank correlation, and one-way analysis of variance (ANOVA) were used for data analysis, with p value <0.05 considered statistically significant.Results: Out of 461 AD-diagnosed children, 212 (46%) were girls, and 249 (54%) were boys. The mean DFI score was 9.64 (±6.44), with 32.3% presenting with mild AD, 46.2%) being moderate, and 21.5% with severe AD. The primary caregivers were mostly first-degree family members, with 62% being mothers and 27.2% fathers. A significant correlation was found between the DFI score and the SCORAD index (p<0.0001). The components of quality of life that were adversely affected included sleep, leisure activities, food preparation, emotional distress, tiredness of the caregiver, involvement in treatment, and family relationships. The DFI score was influenced by family occupation, parental education, and comorbidity in children with AD.Conclusion: Caring for a child with AD adversely affects caregivers or family QoL, which further declines as disease severity increases. This underscores the need for targeted support for caregivers, including practical care management and educational resources, to improve both child and family outcomes.