The prevalence of atopic dermatitis in black Caribbean children in London and Kingston, Jamaica

It has been suggested that black children of West Indian origin living in London have a higher prevalence of atopic dermatitis (AD) than their counterparts living in the Caribbean. (Williams HC et. al London-born black Caribbean children are at increased risk of atopic dermatitis. J Am Acad Dermatol 1995; 32: 212-7). To test this hypothesis, we undertook a colloborative study on the prevalence of atopic dermatitis in school children in Lambeth, London and Kingston, Jamaica. Questionnaires were sent to 2126 and 3957 parents of children aged 4 to 11 years attending seven primary schools in London and six schools in Kingston respectively. The questionnaires requested screening information on symptoms of AD and parentally nominated ethnic group of the child. Children whose parents responded affirmatively to the presence of an itchy rash or the presence of generally dry skin (N=562) were examined during two visits to the schools in London. In Kingston, all children whose parents responded and gave consent were examined (N=3027) by the same dermatologist. Cases of AD were defined using the UK Working Party's Diagnostic Criteria. The overall response rate in London and Kingston was 70.3 percent and 86.2 percent respectively. The overall prevalence of AD was 10.8 percent (162/1495) and 4.9 percent (166/3409) in London and Kingston respectively. The prevalence of AD in black children living in London was 18.9 percent (60/317) compared with 4.6 percent (94/2029). These results suggest that black Caribbean children in London are at an increased risk (odds ratio 4.81, 95 percent confidence interval 3.3 to 6.9, p