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Agrawal S, Iqbal S, Patel SJ, Freishtat R, Kochhar-Bryant C. Quality of life in at-risk school-aged children with asthma. J Asthma 2020; 58:1680-1688. [PMID: 32942908 DOI: 10.1080/02770903.2020.1825732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Asthma is the most common chronic condition of childhood. Urban, minority children from families of lower socioeconomic status have disproportionately higher rates of asthma and worse outcomes. We investigated the association between the presence of asthma and asthma severity among American, urban, minority children and reported quality of life (QOL) of children and their families. METHODS We performed a prospective, cross-sectional study comparing QOL of urban, minority elementary school-age children with and without asthma. A convenience sample of children was enrolled from the pediatric emergency department (ED) and a specialized asthma clinic, at a large urban children's hospital. We measured child and parent QOL using the Pediatric Quality of Life Inventory Version 4 (PEDSQL4), and evaluated associations with asthma, parental educational attainment, and frequency of ED visits. RESULTS We enrolled 66 children, 76% were African American, and 61% were female. Overall child QOL was higher for those without asthma (p = 0.017, d = 0.59). Children with asthma also visited the ED almost twice as frequently (t [64] = -3.505, p < 0.001, d = 0.8), and parents of children with asthma reported a lower overall QOL (p = 0.04, d = 0.53) than those without asthma. Among children with asthma, a higher overall child QOL was associated with decreased asthma severity, more ED visits, and higher parental educational attainment. CONCLUSIONS Urban, minority elementary school-age children with asthma report a lower QOL than those children without asthma, and decreased asthma severity was associated with higher QOL.
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Affiliation(s)
- Seema Agrawal
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sabah Iqbal
- Division of Emergency Medicine, Children's National Hospital, Washington, DC, USA
| | - Shilpa J Patel
- Division of Emergency Medicine, Children's National Hospital, Washington, DC, USA
| | - Robert Freishtat
- Division of Emergency Medicine, Children's National Hospital, Washington, DC, USA
| | - Carol Kochhar-Bryant
- Special Education and Disability Studies, The George Washington University, Washington, DC, USA
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Mekonnen H, Medhin G, Tomlinson M, Alem A, Prince M, Hanlon C. Impact of child emotional and behavioural difficulties on educational outcomes of primary school children in Ethiopia: a population-based cohort study. Child Adolesc Psychiatry Ment Health 2020; 14:22. [PMID: 32467725 PMCID: PMC7231403 DOI: 10.1186/s13034-020-00326-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 05/05/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The relationship between child emotional and behavioural difficulties (EBD) and educational outcomes has not been investigated in prospective, community studies from low-income countries. METHODS The association between child EBD symptoms and educational outcomes was examined in an ongoing cohort of 2090 mother-child dyads. Child EBD was measured when the mean age of children was 6.5 years, SD 0.04 (T0) and 8.4, SD 0.5 years (T1) using the Strength and Difficulties Questionnaire (SDQ). Educational outcomes were obtained from maternal report (drop-out) at T1 and from school records at when the mean age of the children was 9.3 (SD 0.5) years (T2). RESULT After adjusting for potential confounders, child EBD symptoms at T1 were associated significantly with school absenteeism at T2: SDQ total score: Risk Ratio (RR) 1.01; 95% confidence interval (CI) 1.01, 1.02; SDQ high score (≥ 14) RR 1.36; 95% CI 1.24, 1.48; emotional subscale RR 1.03; 95% CI 1.01, 1.04; hyperactivity subscale RR 1.03; 95% CI 1.02, 1.04 and peer problems subscale (RR 1.02; 95% CI 1.00, 1.04). High SDQ (β = - 2.89; 95% CI - 5.73, - 0.06) and the conduct problems sub-scale (β = - 0.57; 95% CI - 1.02, - 0.12) had a significant negative association with academic achievement. There was no significant association between child EBD and school drop-out. CONCLUSION Prospective associations were found between child EBD symptoms and increased school absenteeism and lower academic achievement, suggesting the need for child mental health to be considered in interventions targeting improvement of school attendance and academic achievement in low-income countries.
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Affiliation(s)
- Habtamu Mekonnen
- grid.7123.70000 0001 1250 5688Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia ,grid.411903.e0000 0001 2034 9160Department of Psychology, College of Education and Behavioural Sciences, Jimma University, Jimma, Ethiopia
| | - Girmay Medhin
- grid.7123.70000 0001 1250 5688Aklilu-Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mark Tomlinson
- grid.11956.3a0000 0001 2214 904XDepartment of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Atalay Alem
- grid.7123.70000 0001 1250 5688Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Martin Prince
- grid.13097.3c0000 0001 2322 6764Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Charlotte Hanlon
- grid.7123.70000 0001 1250 5688Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia ,grid.13097.3c0000 0001 2322 6764Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.7123.70000 0001 1250 5688Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Saleh ASEM. School asthma intervention programme effectively improved children's knowledge and attitudes, and led to decreased hospital admission, length of stay and school absences. Evid Based Nurs 2019; 23:92. [PMID: 31427502 DOI: 10.1136/ebnurs-2019-103092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2019] [Indexed: 11/04/2022]
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Al-khateeb AJ, Al khateeb JM. Research on psychosocial aspects of asthma in the Arab world: a literature review. Multidiscip Respir Med 2015; 10:15. [PMID: 25905019 PMCID: PMC4405861 DOI: 10.1186/s40248-015-0011-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/17/2015] [Indexed: 12/23/2022] Open
Abstract
The importance of psychosocial factors in the management of bronchial asthma has long been recognized. This paper offers a review of research published in the English language related to psychosocial aspects of bronchial asthma in Arab countries. Several databases (PubMed, Science Direct, Springer Link, ERIC, and PsychInfo) were searched using the following keywords: bronchial asthma, Arab countries, Algiers, Bahrain, Comoros, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine (West Bank, Gaza), Qatar, Saudi Arabia, Syria, Tunisia, Sudan, Somalia; United Arab Emirates, and Yemen. Thirty-two studies were conducted in 9 Arab countries. Almost all studies found were published in the last fourteen years with an apparent increasing rate in the last five years. In descending order, these studies addressed: knowledge of and attitudes toward asthma, quality of life, behavioral and emotional problems and factors related to academic achievement. The main results of the studies reviewed were: (a) physicians', school staff's, and parents' knowledge of and attitudes toward asthma were generally unsatisfactory, (b) in-service asthma education programs significantly impacted parent and staff knowledge and attitudes, and asthma management practices, (c) quality of life in children and adolescents was significantly adversely affected by asthma, (d) asthma was a common cause of school absenteeism, and had a significant negative impact on academic achievement of students, and (e) students with asthma had significantly higher rates of behavioral and emotional difficulties compared to students without asthma. The paper concludes with a discussion about the implications of these results and a call for further research in this area.
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Affiliation(s)
- Anas J Al-khateeb
- />Internal Medicine Department, Saint Michael’s Medical Center, 111 Central Avenue, Newark, New Jersey 07102 USA
| | - Jamal M Al khateeb
- />Department of Counseling & Special Education, College of Education, University of Jordan, Queen Rania Street, Amman, 119942 Jordan
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Sweileh WM, Al-Jabi SW, Zyoud SH, Sawalha AF. Bronchial asthma and chronic obstructive pulmonary disease: research activity in Arab countries. Multidiscip Respir Med 2014; 9:38. [PMID: 25050176 PMCID: PMC4105064 DOI: 10.1186/2049-6958-9-38] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 06/23/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chronic respiratory diseases, like bronchial asthma and chronic obstructive pulmonary disease (COPD), are a worldwide health problem. Quantitative and qualitative assessment of asthma and COPD-related research from Arab countries has not been explored and there are few internationally published reports on such field. The main objectives of this study were to analyze research output originating from Arab countries in the field of bronchial asthma and COPD. METHODS Original scientific articles or reviews published from the 22 Arab countries were screened using specific words pertaining to asthma and COPD using Scopus database and search engine. Research productivity was evaluated based on: (a) total and trends of contribution of each Arab country to asthma and COPD research and (b) journals in which researchers from Arab countries published their research. RESULTS The total number of original research and review articles published globally about bronchial asthma and COPD was 163,964. The leading country in bronchial asthma and COPD research was United States of America (38,632; 23.56%). Worldwide, Turkey ranked 19th while Israel and Iran ranked 25th and 29th respectively. Among Arab countries, Egypt and Kingdom of Saudi Arabia came on positions 39th and 43rd, respectively. A total of 1,304 documents about bronchial asthma and COPD were published from Arab countries which represents 0.8% of the global research output. Research in bronchial asthma was almost double that in COPD. Research from Arab countries was low and showed a significant increase after 2000. Approximately 12% of research activity in asthma and COPD from Arab countries was published in Saudi Medical Journal, Annals of Saudi Medicine, Eastern Mediterranean Health Journal and Tunisie Medicale. Kingdom of Saudi Arabia, with a total publication of 353 (27.07%) ranked first among the Arab countries while University of Kuwait was the most productive institution with a total of 123 (9.43%) documents. CONCLUSIONS The present data showed relatively low research productivity about bronchial asthma and COPD in Arab countries. Research output can be improved by investing more in international and national collaborative research projects in the field of asthma and COPD.
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Affiliation(s)
- Waleed M Sweileh
- Department of Pharmacology/Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sa’ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ansam F Sawalha
- Department of Pharmacology/Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Kawafha MM, Tawalbeh LI. The effect of asthma education program on knowledge of school teachers: a randomized controlled trial. West J Nurs Res 2014; 37:425-40. [PMID: 24682383 DOI: 10.1177/0193945914528070] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine the effect of an asthma education program on schoolteachers' knowledge. Pre-test-post-test experimental randomized controlled design was used. A multistage-cluster sampling technique was used to randomly select governorate, primary schools, and schoolteachers. Schoolteachers were randomly assigned either to the experimental group (n = 36) and attended three educational sessions or to the control group (n = 38) who did not receive any intervention. Knowledge about asthma was measured using the Asthma General Knowledge Questionnaire for Adults (AGKQA). The results indicated that teachers in the experimental group showed significantly (p < .001) higher knowledge of asthma in the first post-test and the second post-test compared with those in the control group. Implementing asthma education enhanced schoolteachers' knowledge of asthma. The asthma education program should target schoolteachers to improve knowledge about asthma.
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Siriwardhana C, Pannala G, Siribaddana S, Sumathipala A, Stewart R. Impact of exposure to conflict, tsunami and mental disorders on school absenteeism: findings from a national sample of Sri Lankan children aged 12-17 years. BMC Public Health 2013; 13:560. [PMID: 23758997 PMCID: PMC3698150 DOI: 10.1186/1471-2458-13-560] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 06/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Armed conflicts and natural disasters are common. Millions of people, including children are killed, injured, disabled and displaced as a result. The effects of conflict and natural disaster on mental health, especially of children are well established but effects on education have received less attention. This study investigated associations between conflict and/or tsunami exposure in Sri Lanka and their associations with absenteeism in a national sample of school children. METHODS A cross-sectional survey was conducted in 2006-7 among 1,505 randomly selected school children aged 12-17 years attending government schools in 17 districts. The hypotheses were that absenteeism would be more common in children previously affected by conflict or the 2004 tsunami and that at least part of this effect would be accounted for by mental disorders. Survey information included socio-demographic, conflict and tsunami exposure, mental health status (Strengths and Difficulties Questionnaire) and information on absenteeism (defined as 20% or greater non-attendance over one year). RESULTS The total sample of consisted of 1,505 students aged 12-17 years with a mean age of 13.7 years. 120 children reported at least one conflict exposure and 65 reported at least one tsunami exposure while only 15 reported exposure to both conflict and tsunami. Prevalence of emotional disorder caseness was 2.7%, conduct disorder caseness 5.8%, hyperactivity disorder caseness 0.6%, and 8.5% were identified as having any psychiatric disorder. Absenteeism was present in 26.8%. Overall, previous exposure to tsunami (OR 2.29 95% CI 1.36-3.84) was significantly associated with absenteeism whereas exposure to conflict was not (OR 1.32 95% CI 0.88-1.97), although some specific conflict-related exposures were significant risk factors. Mental disorder was strongly associated with absenteeism but did not account for its association with tsunami or conflict exposure. CONCLUSIONS Exposure to traumatic events may have a detrimental effect on subsequent school attendance. This may give rise to perpetuating socioeconomic inequality and needs further research to inform policy and intervention.
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Affiliation(s)
- Chesmal Siriwardhana
- Health Service & Population Research Department, Institute of Psychiatry, King's College London, UK.
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Bener A, Kamal M, Shanks NJ. Impact of asthma and air pollution on school attendance of primary school children: are they at increased risk of school absenteeism? J Asthma 2007; 44:249-52. [PMID: 17530520 DOI: 10.1080/02770900701246725] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The aim of this study was to determine the impact of asthma and air pollution on school attendance of primary school children 6 to 12 years of age in Qatar. STUDY DESIGN This was a cross-sectional population-based study. SUBJECTS The total 31,400 Qatari school children at the primary school (16,130 boys and 15,270 girls) 6 to 12 of age were studied to investigate school absenteeism caused by asthma and wheezing during the academic year October 2003 to July 2004. METHODS We have used the School Health Registry for obtaining the student information and school absenteeism due to asthma and wheezing. Again we had double confirmation on the data obtained on asthmatic children by using the modified version of the International Study of Asthma and Allergies in Childhood [ISAAC] questionnaire. RESULTS A total of 3,270 (10.4%) pupils were diagnosed as having asthma and wheezing. Overall 2,516 (8.02%) pupils were absent from the school for at least one day during the year. There was a statistically significant difference between asthmatic and wheezing students in number of days absent from the school (p < 0.0001). Most absenteeism occurred during spring for both boys (45%) and girls (47%), followed by autumn for boys (33%) and girls (36%). The measured pollutants reached a peak during the spring season and then in autumn of the studied academic year. CONCLUSION Children with known asthma miss more days of school than those who do not have asthma. This study finding shows that air pollution has an impact on asthma, which results in significant school absenteeism.
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Affiliation(s)
- Abdulbari Bener
- Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Doha, Qatar.
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Bonilla S, Kehl S, Kwong KYC, Morphew T, Kachru R, Jones CA. School absenteeism in children with asthma in a Los Angeles inner city school. J Pediatr 2005; 147:802-6. [PMID: 16356435 DOI: 10.1016/j.jpeds.2005.06.041] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Revised: 05/19/2005] [Accepted: 06/21/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the pattern of school absenteeism in asthmatic children within a Los Angeles inner city school. STUDY DESIGN Five hundred twenty-eight students of predominant Hispanic ethnicity, from a Los Angeles inner city school were divided into 3 groups: known asthma, high probability of asthma, and low probability of asthma using a previously validated instrument. Attendance records of these students were analyzed to determine total and respiratory absences over a year. School records were compared to the corresponding answers on 513 surveys to determine the accuracy of parental responses in regard to their children's absenteeism. RESULTS Children with known asthma missed on average 2 more days of school than children with low probability of asthma and high probability of asthma. This was only significant in the younger age groups. Survey responses were found to have a 45.6% agreement with school attendance records. Underestimation occurred more often when school-recorded absentee rates were highest. Overestimation occurred more by parents of children with known asthma or a high probability of asthma. CONCLUSION In a Los Angeles inner city population, younger children with known asthma miss more days of school than those with no asthma. Survey-reported absenteeism is less accurate than school attendance records.
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Affiliation(s)
- Sheila Bonilla
- Division of Allergy-Immunology, Department of Pediatrics, Los Angeles County+University of Southern California Medical Center, Los Angeles Calif 90033, USA
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Shohat T, Graif Y, Garty BZ, Livne I, Green MS. The child with asthma at school: results from a national asthma survey among schoolchildren in Israel. J Adolesc Health 2005; 37:275-80. [PMID: 16182137 DOI: 10.1016/j.jadohealth.2004.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2004] [Revised: 11/03/2004] [Accepted: 12/13/2004] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate school absence and restriction in school activities of children with asthma, and to estimate the involvement of the school staff in asthma disabilities. METHODS A modified version of the International Study of Asthma and Allergies in Childhood written questionnaire was administered to a national sample of 13-14-year-old schoolchildren across Israel. Questions regarding social and demographic factors, school absence owing to asthma symptoms, and school staff involvement were added. RESULTS There were 10,057 complete questionnaires available for analysis; 710 children reported having asthma. Children with asthma were absent on the average 7.3 +/- 9.8 days in the past school year compared with 3.9 +/- 6.3 days in children without (p = .0001). Absenteeism owing to respiratory symptoms was significantly more common in children with asthma and associated with a more severe asthmatic condition. Four percent of the children with asthma were absent from school more than 30 days. Of the children reporting asthma, 25.9% were not allowed to participate in one or more school activities for medical reasons, compared with 4.2% of children without asthma. Of the children with asthma, 44.3% reported that the school nurse knew about their asthma, and only 13.8% reported that the nurse discussed their asthmatic condition with them; 38.2% of children with asthma reported that no one at school knew about their illness. CONCLUSIONS Children with asthma are absent annually on average 3.4 days more than children without asthma. School absence is associated with the severity of asthma. A significant percentage of asthmatic children participate less in school activities. School staff awareness of the children illness is not satisfactory.
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Affiliation(s)
- Tamar Shohat
- The Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel.
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Milton B, Whitehead M, Holland P, Hamilton V. The social and economic consequences of childhood asthma across the lifecourse: a systematic review. Child Care Health Dev 2004; 30:711-28. [PMID: 15527481 DOI: 10.1111/j.1365-2214.2004.00486.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Asthma prevalence rates are high, and may be increasing in the Western world, particularly among children. The aim of this study was to evaluate the longer-term social and economic consequences of having asthma as a child and to determine whether adverse consequences are more severe for poorer children. METHODS Results from published and unpublished, quantitative and qualitative studies were synthesized narratively to examine the impact of childhood-onset asthma on school attendance, academic achievement and employment in adulthood. The question of whether the impact differed for different social groups was also examined. FINDINGS Twenty-nine good quality studies were identified, including in total 12 183 children with asthma or wheeze. Compared with asymptomatic children, those with asthma missed more days of school (additional absence as a result of asthma ranged from 2.1 to 14.8 days). Studies of academic achievement found that children with asthma performed as well as their healthy peers. The existing evidence on labour market performance is sparse, but there is an indication that people with asthma during childhood experience disadvantage in later employment. In an examination of consequences by social position, children with asthma from deprived areas were more likely to miss school than their more affluent peers, and minority ethnic children were also more likely to have poor school attendance. The only qualitative study suggested that children with asthma strove to participate fully in every aspect of their daily lives. INTERPRETATION Although asthma limits children's daily activities and affects their social activities, this research synthesis found little evidence of major, adverse long-term social and economic consequences in studies reviewed. Further longitudinal research using comparison groups is needed to fill key gaps in the existing evidence base.
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Affiliation(s)
- B Milton
- Department of Public Health, University of Liverpool, Liverpool, UK.
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