METHODS: We investigated a cohort of AA children(≤3 yrs.) with AD living in an urban environment in the United States. All parents completed a standardized questionnaire consisting of a history of atopic conditions, and a SCORAD questionnaire. We compared these variables to a cohort of Black South African (SA) children(≤3 yrs.) with AD living in urban and rural environments in South Africa.
RESULTS: The AA and SA cohorts consisted of 68 and 63 children with AD respectively. The two cohorts had similar age and gender distribution. The SA cohort had significantly higher SCORAD scores in comparison to the AA(mean ±SD of 29.55±25vs.513.37±12.7). While the prevalence of allergic rhinitis was comparable among the two cohorts(22.1%vs.22.2%), the AA cohort had significantly more children with asthma(1.6%vs.20.6%) and SA children had more food allergy(14.7%vs.30.2%). Of the SA cohort, 34 children were from rural and 29 from urban areas. Adjusting the data based on rural vs. urban location did not yield any changes.
CONCLUSIONS: The differences between two cohorts of Black children from different countries with higher severity of AD among SA children could be due to lower access to health care, genetic differences between AA and SA, or environmental factors, which could result in increased disruption of the skin barrier and the rate of atopic comorbidities.