Abstract
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.