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Cross-Sectional Study to Estimate the Prevalence of AD and Identify the Risk Factors Associated with its Development in the Rural Community of India

Purkshish Kaushal, Sanjeev Handa, Rahul Mahajan, Dipankar De, Ravindra Khaiwal

Introduction: Atopic Dermatitis (AD) is a chronic, inflammatory, relapsing dermatological disorder with onset at an early age.

Objective: This study was done to estimate the prevalence of AD in a rural community setting in North Indian population using UK Working Party criteria for AD and to assess the association of risk factors with AD by comparing with a non-AD subgroup in the study population.

Materials and methods: Consecutive patients with a diagnosis of AD (as assessed using Hanifin and Rajka criteria) were pooled out from 495 participating children from the Fatehgarh district of Punjab (30.6435°N, 76.3970°E). Various clinical and epidemiological features were considered and the significantly associated risk factors were evaluated by comparing the AD and non-AD subgroups.

Results: Out of 495 participants, seventeen participants (3.4%) were diagnosed with atopic dermatitis. Sixteen (3.2%), participants were in the age group ≤ 1 year, 118(23.8%) between 1 to 5 years and 361(72.9%) were >5 years of age respectively. Male to female ratio in these age groups was 1:1.06 in less than 1 year age group, 0.8: 1 in 1 to 5 year age groups and 1.06:1 in the 6 to 18 years age group. In our study, various risk factors were assessed with respect to their association with AD using univariable and multi variable regression analysis. The regression coefficient was significant for daycare centers, early use of antibiotics and tendency for cutaneous infection, in both univariable and multivariable analysis while use of curd during first two years of life was protective in the univarible regression analysis.

Conclusion: There are only a few studies from India on the prevalence of AD but none from a community setting. We observed a lower prevalence of AD in the rural community. An early exposure to antibiotics and attendance at day care centers (Anganwaris) was seen to be associated with the development of AD. More epidemiological studies on childhood and adulthood AD in different areas of the country are needed to see the real burden of disease.