Community-based Survey For AD Prevalence With Comprehensive Intervention:a Model Study Focusing On School-age Children In Shanghai, China

1. Community-based survey for skin barrier function of children with atopic dermatitisObjective We evaluated the differences of the skin barrier function between children with atopic dermatitis(AD) and healthy control through testing the transepidermal water loss(TEWL) and stratum corneum(SC) hydration and we also assessed the correlation between the clinical severity and the skin barrier function.Methods169AD patients and142healthy controls aged3-12years old from two of the Shanghai communities (Changning Xining community and Jiading Juyuan community) were recruited. TEWL and SC hydration were measured on non-lesional normal appearing skin at4sites (the dorsal arm, volar forearm, cheek and lower leg). AD severity was assessed by using the SCORAD index. Statistical software was SPSS19.0.Results (1) Comparasion of the skin barrier function between AD patients and healthy controls:TEWL of AD patients were significantly higher than healthy controls in all tested sites. SC hydration level of AD patients were significantly lower than healthy controls especially on the dorsal arm and lower leg tested sites.(2) The clinical severity of AD was positively related with TEWL and negatively related with SC hydration.Conclusions The results of our study showed the skin barrier function had significantly been changed even in non-lesional skin in AD patients and the clinical severity showed a statistically significantly related in AD which indicated that the biophysical measurement of skin barrier function in skin of AD may work as an evaluation factor for AD severity. 2. Community-based survey for AD prevalence with comprehensive intervention: A model study focusing on school-age children in Shanghai, ChinaObjective The primary objective of this study was to measure the effect of an education program through the local community health care center on disease severity, quality of life in patient and their family with atopic dermatitis.Methods Based on the work of the AD’s prevalence in the community-based survey and the investigation of the risk factors which cause its relapse we have preliminary concluded.We have conducted the epidemiological survey in2010of the AD children aged from3to12years old in8communities in different districts in Shanghai from two of which we screened out patients with AD. In general, this survey lasted one year and after the educational intervention, we evaluate some indices, comparing the results between the group receiving the education and non-receiving one, including SCORAD scoring, TEWL, Hydration capacity and CDQOL or IDQOL, DFI. We classify Xinjing community as intervention group and Juyuan community as control group. A total of107school-age children (6-12years) diagnosed with atopic dermatitis were involved.Result Our study showed that the intervention group had a significant improvement in the scoring dermatitis measure when compared to the control group after one year follow up. Quality of life of children also have significant improvement while dermatitis family impact didn’t significant improve with decrease severity of eczema.Conclusion These findings suggest that community-based educational intervention could be an useful model for the AD research and have a favourable effect on the clinical appliance, in that way, we can generalize this model nationally or even internationally.