Household and Environmental Determinants Influencing Atopic Dermatitis Among Young Rural Children in the Ehlanzeni District Municipality

Highlights: Public health relevance—How does this work relate to a public health issue? Atopic dermatitis (AD) remains a prevalent condition among young children in both urban and rural settings. Access to primary health services for the management of atopic dermatitis is constrained in rural regions. Public health significance—Why is this work of significance to public health? The prevalence of atopic dermatitis in rural areas is comparable to that observed in urban areas, where there is a greater volume of research conducted. Exposure to second-hand smoke within the household environment serves as a trigger for atopic dermatitis in rural populations. The use of traditional, homemade utensils is a contributing factor to the onset of atopic dermatitis in children residing in rural areas. Public health implications—What are the key implications or messages for practitioners, policy makers, and/or researchers in public health? There is a necessity for the implementation of environmental health programs, such as educational campaigns, to facilitate the prevention of AD. Background: This study aimed to determine the prevalence of atopic dermatitis (AD), as well as the determinants that contribute to its development, particularly household and environmental determinants, in young children residing in a rural area in South Africa. There is a lack of scientific evidence regarding the determinants, particularly environmental factors, of AD among children living in rural areas. Therefore, this study aimed to identify the household and environmental determinants influencing atopic dermatitis in young rural children in the Ehlanzeni District Municipality. Methods: A cross-sectional analytical study was conducted, wherein mothers/caregivers and their children were purposefully recruited as participants. Data collection involved the utilization of an adapted version of the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC), which was then analyzed using Stata MP version 18. Result: The study included a total of 881 mothers/caregivers, with a majority of the child participants being boys (n = 477, 54.14%). The prevalence rates of historical and current AD were found to be 13.96% and 18.62%, respectively. Natural birth was found to be a protective factor for both history (Adjusted Odds Ratio [AOR]: 0.094; p < 0.001) and current (AOR: 0.261: <0.001) AD. The use of a traditional broom for sweeping the floor, exposure to household environmental tobacco smoking, and residing in a household that has ongoing renovations were associated with both history and current AD. Conclusions: These findings demonstrate that the prevalence of AD in rural areas is high among children. Consequently, there is a need to provide primary health care services, particularly for skin diseases, which are currently limited in rural areas. Additionally, environmental health services could play a crucial role in the management and control (especially proactive programs such as educational campaigns) of AD and similar conditions in rural areas.