POEM is a seven-item, validated questionnaire [2325] that measures the frequency of child symptoms including itch, sleep disturbance, bleeding, weeping or oozing, and cracked, dry, and flaking skin. The main caretaker, typically the mother of the child, responded on behalf of the child. Each question was scored from 0 = ‘No days’ to 4 = ‘Every day’ for a maximum score of 28. We used previously validated score bands to categorize participants: clear (score 0–2), mild (score 3–7), moderate (score 8–16), severe (score 17–24), and very severe (score 25–28) [26].

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