Environmental factors associated with atopic dermatitis in children in urban and rural South Africa

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dc.contributor.advisorLondon, Leslie
dc.contributor.advisorTodd, Gail
dc.contributor.authorDewar, Janine
dc.date.accessioned2025-10-31T11:33:35Z
dc.date.available2025-10-31T11:33:35Z
dc.date.issued2025
dc.date.updated2025-10-31T11:27:01Z
dc.description.abstractBackground: Environmental exposures related to modern urban living, and the absence of protective rural exposures, may contribute to the high prevalence of childhood atopic dermatitis (AD). Objectives: To identify environmental exposures associated with AD in children living in three residential areas of South Africa. Methods: A total of 3144 children aged 3 to 11 years participated in 1999 in a cross-sectional study involving a suburban area, peri-urban informal settlement, and several villages in a remote rural district in South Africa. Caregivers of children within a modified case control subset of 739 children, consisting of 253 cases and 486 controls, completed a researcher-led 57-point questionnaire on environmental exposures. Bivariate and multivariate logistic regression models were used to determine statistically significant associations between environmental exposures and AD. Results: A total of 387 children in the urban area, 59 in the peri-urban area and 293 in the rural district were included. Mean age of participants was 6.8 years, and 53.9% were female. Multivariate analysis found that current exposure to mould (aOR 2.79; 95% CI 1.58 – 5.00), pesticides (aOR 1.73; 95% CI 1.24 – 2.42), stress events (aOR 2.37; 95% CI 1.19 – 4.75) and home infestation with fleas (aOR 1.73; 95% CI 1.24 – 2.42) increased odds of AD in our study population, as did weaning after 4 months (aOR 1.83; 95% CI 1.31 – 2.56), compared to earlier weaning. Conclusion: Our findings underscore the need for targeted interventions addressing indoor environmental air quality, use of indoor pesticides, and the impact of psychological stressors on the development of AD.
dc.identifier.apacitationDewar, J. (2025). <i>Environmental factors associated with atopic dermatitis in children in urban and rural South Africa</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/42075en_ZA
dc.identifier.chicagocitationDewar, Janine. <i>"Environmental factors associated with atopic dermatitis in children in urban and rural South Africa."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025. http://hdl.handle.net/11427/42075en_ZA
dc.identifier.citationDewar, J. 2025. Environmental factors associated with atopic dermatitis in children in urban and rural South Africa. . University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/42075en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Dewar, Janine AB - Background: Environmental exposures related to modern urban living, and the absence of protective rural exposures, may contribute to the high prevalence of childhood atopic dermatitis (AD). Objectives: To identify environmental exposures associated with AD in children living in three residential areas of South Africa. Methods: A total of 3144 children aged 3 to 11 years participated in 1999 in a cross-sectional study involving a suburban area, peri-urban informal settlement, and several villages in a remote rural district in South Africa. Caregivers of children within a modified case control subset of 739 children, consisting of 253 cases and 486 controls, completed a researcher-led 57-point questionnaire on environmental exposures. Bivariate and multivariate logistic regression models were used to determine statistically significant associations between environmental exposures and AD. Results: A total of 387 children in the urban area, 59 in the peri-urban area and 293 in the rural district were included. Mean age of participants was 6.8 years, and 53.9% were female. Multivariate analysis found that current exposure to mould (aOR 2.79; 95% CI 1.58 – 5.00), pesticides (aOR 1.73; 95% CI 1.24 – 2.42), stress events (aOR 2.37; 95% CI 1.19 – 4.75) and home infestation with fleas (aOR 1.73; 95% CI 1.24 – 2.42) increased odds of AD in our study population, as did weaning after 4 months (aOR 1.83; 95% CI 1.31 – 2.56), compared to earlier weaning. Conclusion: Our findings underscore the need for targeted interventions addressing indoor environmental air quality, use of indoor pesticides, and the impact of psychological stressors on the development of AD. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Rural KW - Urban KW - Children KW - South Africa LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Environmental factors associated with atopic dermatitis in children in urban and rural South Africa TI - Environmental factors associated with atopic dermatitis in children in urban and rural South Africa UR - http://hdl.handle.net/11427/42075 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42075
dc.identifier.vancouvercitationDewar J. Environmental factors associated with atopic dermatitis in children in urban and rural South Africa. []. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42075en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectRural
dc.subjectUrban
dc.subjectChildren
dc.subjectSouth Africa
dc.titleEnvironmental factors associated with atopic dermatitis in children in urban and rural South Africa
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPH
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