The quality of life of caregivers of children with atopic dermatitis in a South African setting

Background. Atopic dermatitis (AD) is known to adversely affect patients' quality of life (QOL). However, less is known about the extent to which caregivers are affected, particularly in developing countries. Objectives. To investigate factors affecting QOL in caregivers of children with AD in the South African (SA) setting and to document the associated effect of disease severity. Methods. This was a prospective study of 142 AD patients and their caregivers attending Grey's Hospital in KwaZulu-Natal, SA, between May and September 2016. Disease severity was assessed according to the Objective Scoring of Atopic Dermatitis (Objective SCORAD) index. The Dermatitis Family Impact (DFI) questionnaire was used to assess QOL. Results. The study population included 119 (84%) black, 20 (14%) Indian and 3 (2%) coloured patients. Among the group, 44% of cases (n=62) were classified as mild, 53% (n=76) as moderate and 3% (n=4) as severe. The DFI score was significantly associated with the Objective SCORAD index (p<0.0001). QOL factors significantly affected were emotional distress of the caregiver (p<0.0001), tiredness of the caregiver (p<0.0001) and family leisure activities (p<0.0001). Involvement in treatment (p=0.016), food preparation and feeding (p=0.003), the family's sleep (p=0.001) and the caregiver's relationships (p=0.025) were moderately affected. Conclusion. The QOL of caregivers of children with AD in this setting was adversely affected and declined with increasing disease severity. An evaluation of the psychosocial health of caregivers and appropriate referral where necessary are important for holistic management of both the patient and the caregiver and to improve disease outcome

Cutaneous manifestations of HIV/AIDS: Part I

Human immunodeficiency virus (HIV) infection can lead to a variety of clinical cutaneous manifestations. These cutaneous disorders occur universally during the course of HIV infection. Cutaneous manifestations of HIV are very diverse. The course and clinical presentation of HIV in individuals who have access to highly active antiretroviral therapy (HAART) is completely different from that in those who do not. Many of the HIV cutaneous presentations seen in South Africa become chronic and progressive. There is a marked reduction in the incidence of opportunistic infections and neoplasms in North America; Western Europe and Australia; where there is access to HAART. Approximately 90 of patients will develop one or more skin diseases during the course of their illness. It is therefore crucial that health professionals become familiar with and are able to recognise the various skin manifestations of HIV