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Janus M, Reid-Westoby C, Pottruff M, Schneeweiss M, Hu G, Brownell M. Developmental health of Canadian kindergarten children with teacher-reported asthma between 2010 and 2015: A population-level cross-sectional study. Prev Med Rep 2024; 37:102525. [PMID: 38186657 PMCID: PMC10767499 DOI: 10.1016/j.pmedr.2023.102525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
Asthma can impact children's quality of life. It is unclear how asthma is associated with the developmental health (i.e. a broad range of skills and abilities associated with growth and development) of young children at school entry. The goals of this cross-sectional, population-level study were to: (1) investigate the association between teacher-reported asthma and children's concurrent indicators of developmental health (developmental vulnerability); and (2) explore whether school absences and functional impairments modified this association. Participants were a Canadian population-based sample of 564 582 kindergarten children (Mage = 5.71 years, SD = 0.32, 51.3 % male) with data on the Early Development Instrument (EDI) collected between 2010 and 2015. Adjusted binary logistic regressions were conducted to address the objectives. From the sample, 958 (0.2 %) children were identified as having a diagnosis of asthma. These children were absent on average 9.4 days and 53.5 % had functional impairments (vs. 6.7 days absent and 15.9 % with functional impairments in children without asthma). After controlling for demographic characteristics, children with asthma had between 1.51 and 2.42 higher odds of being developmentally vulnerable. Only the presence of functional impairments modified this relationship and only for physical health and well-being. In this large, population-based sample of Canadian kindergarten children, few teachers reported knowledge of their students' asthma diagnosis. Among teacher-reported cases, asthma was a risk factor for developmental vulnerability in the domain of physical health and well-being only. Functional impairments may therefore be more detrimental for child development at school entry than asthma alone.
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Affiliation(s)
- Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | - Molly Pottruff
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | - Michelle Schneeweiss
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada
| | - George Hu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada
| | - Marni Brownell
- Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 3P5, Canada
| | - Canadian Children's Health in Context Study Team
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada
- Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 3P5, Canada
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Alanko K, Melander K, Ranta K, Engblom J, Kosola S. Time Trends in Adolescent School Absences and Associated Bullying Involvement Between 2000 and 2019: A Nationwide Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01601-1. [PMID: 37632555 DOI: 10.1007/s10578-023-01601-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
Education is a central determinant of adolescent health. School absences and bullying involvement jeopardize wellbeing, mental health, and educational attainment. We analyzed time trends in school absenteeism over two decades and examined the association of absenteeism with bullying involvement.We analyzed data from the nationwide School Health Promotion study, with self-reported data from Finnish middle school students in grades 8 and 9 (ages 14-17, N = 1 000 970). Questionnaires assessed frequency of illness absences (IA), truancy, frequency of bullying victimization, bullying perpetration, and involvement in both bullying perpetration and victimization. Frequent school absences were defined as occurring on more than 3 days during the prior month (2000-2015), or at least weekly (2017-2019).Frequent IA increased from 12% to 2000 to 22% in 2015. In 2017-2019, frequent IA was reported by 3.5%. Frequent truancy declined from 9% to 2000 to 4% in 2015, and remained at 4% during 2017-2019. Bully victimization was reported at least weekly by 6.9%, perpetration by 5.4% and victimization-perpetration by 1.9% of participants in total. In a logistic regression model, every type of bullying involvement increased odds for both IA and truancy.Since bullying involvement was associated with both IA and truancy, particular concern should be raised for adolescents involved in bullying, and for their social and educational functioning. The concurrent increase in IA and decrease in truancy may reflect destigmatization of mental health problems or other changes in reporting absenteeism.
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Affiliation(s)
- K Alanko
- Faculty of Humanities, Psychology and Theology, Åbo Akademi University, Turku, Finland.
| | - K Melander
- Tampere University Hospital, and University of Tampere, University of Helsinki, Helsinki, Finland
| | - K Ranta
- Faculty of Social Sciences, Faculty of Medicine, Tampere University, University of Helsinki, Tampere, Helsinki, Finland
| | - J Engblom
- Department of Mathematics and Statistics, School of Economics, University of Turku, University of Turku, Turku, Finland
| | - S Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Totsika V, Kouroupa A, Timmerman A, Allard A, Gray KM, Hastings RP, Heyne D, Melvin GA, Tonge B. School Attendance Problems Among Children with Neurodevelopmental Conditions One year Following the Start of the COVID-19 Pandemic. J Autism Dev Disord 2023:10.1007/s10803-023-06025-3. [PMID: 37480438 DOI: 10.1007/s10803-023-06025-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE The present study investigated school absence among 1,076 5-15 year-old children with neurodevelopmental conditions (intellectual disability and/or autism) approximately one year following the start of COVID-19 in the UK. METHODS Parents completed an online survey indicating whether their child was absent from school during May 2021 and the reason for each absence. Multi-variable regression models investigated child, family and school variables associated with absenteeism and types of absenteeism. Qualitative data were collected on barriers and facilitators of school attendance. RESULTS During May 2021, 32% of children presented with persistent absence (missing ≥ 10% of school). School refusal and absence due to ill-health were the most frequent types of absence, accounting for 37% and 22% of days missed, respectively. COVID-19 related absence accounted for just 11% of days missed. Child anxiety was associated with overall absenteeism and with days missed because of school refusal. Parent pandemic anxiety and child conduct problems were not associated with school absenteeism. Hyperactivity was associated with lower levels of absenteeism and school refusal but higher levels of school exclusion. A positive parent-teacher relationship was associated with lower levels of absenteeism, school refusal and exclusion. Child unmet need in school was the most frequently reported barrier to attendance while COVID-19 was one of the least frequently reported barriers. CONCLUSION COVID-19 had a limited impact on school attendance problems during this period. Findings highlighted the role of child mental health in different types of absence and the likely protective role of a positive parent-teacher relationship.
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Affiliation(s)
- Vasiliki Totsika
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK.
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.
- Tavistock & Portman NHS Foundation Trust, London, UK.
| | - Athanasia Kouroupa
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK
| | - Amanda Timmerman
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK
| | - Amanda Allard
- Council for Disabled Children, National Children's Bureau, London, UK
| | - Kylie M Gray
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
| | - David Heyne
- Developmental and Educational Psychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - Glenn A Melvin
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Bruce Tonge
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
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Donaldson AL, Hardstaff JL, Harris JP, Vivancos R, O'Brien SJ. School-based surveillance of acute infectious disease in children: a systematic review. BMC Infect Dis 2021; 21:744. [PMID: 34344304 PMCID: PMC8330200 DOI: 10.1186/s12879-021-06444-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Syndromic surveillance systems are an essential component of public health surveillance and can provide timely detection of infectious disease cases and outbreaks. Whilst surveillance systems are generally embedded within healthcare, there is increasing interest in novel data sources for monitoring trends in illness, such as over-the-counter purchases, internet-based health searches and worker absenteeism. This systematic review considers the utility of school attendance registers in the surveillance of infectious disease outbreaks and occurrences amongst children. METHODS We searched eight databases using key words related to school absence, infectious disease and syndromic surveillance. Studies were limited to those published after 1st January 1995. Studies based in nursery schools or higher education settings were excluded. Article screening was undertaken by two independent reviewers using agreed eligibility criteria. Data extraction was performed using a standardised data extraction form. Outcomes included estimates of absenteeism, correlation with existing surveillance systems and associated lead or lag times. RESULTS Fifteen studies met the inclusion criteria, all of which were concerned with the surveillance of influenza. The specificity of absence data varied between all-cause absence, illness absence and syndrome-specific absence. Systems differed in terms of the frequency of data submissions from schools and the level of aggregation of the data. Baseline rates of illness absence varied between 2.3-3.7%, with peak absences ranging between 4.1-9.8%. Syndrome-specific absenteeism had the strongest correlation with other surveillance systems (r = 0.92), with illness absenteeism generating mixed results and all-cause absenteeism performing the least well. A similar pattern of results emerged in terms of lead and lag times, with influenza-like illness (ILI)-specific absence providing a 1-2 week lead time, compared to lag times reported for all-cause absence data and inconsistent results for illness absence data. CONCLUSION Syndrome-specific school absences have potential utility in the syndromic surveillance of influenza, demonstrating good correlation with healthcare surveillance data and a lead time of 1-2 weeks ahead of existing surveillance measures. Further research should consider the utility of school attendance registers for conditions other than influenza, to broaden our understanding of the potential application of this data for infectious disease surveillance in children. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2019 CRD42019119737.
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Affiliation(s)
- A L Donaldson
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
- Field Epidemiology Service, Public Health England, Liverpool, UK.
| | - J L Hardstaff
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - J P Harris
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - R Vivancos
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
- Field Epidemiology Service, Public Health England, Liverpool, UK
| | - S J O'Brien
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
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Flewelling KD, Koehler A, Shaffer J, Dill EJ. Medical and psychosocial outcomes of youth with psychogenic nonepileptic seizures: An observational study. Epilepsy Behav 2020; 112:107383. [PMID: 32882629 DOI: 10.1016/j.yebeh.2020.107383] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Few studies have examined both medical and psychosocial outcomes of youth with psychogenic nonepileptic seizures (PNES). The current observational study aimed to fill this gap by examining changes in seizure frequency, school absences, emergency department (ED) visits, psychological functioning, and health-related quality of life (HRQoL) in youth attending a clinic for brief treatment of PNES. METHODS Nineteen youth with PNES and their families presented to an integrated clinic and received psychoeducation and recommendations by medical and mental health professionals. Patients returned to the clinic, on average six months later, for follow-up. Parent proxy-report and self-report measures of psychological functioning and HRQoL were collected at each visit, and medical data were extracted from patient charts. RESULTS Forty-six percent of youth in the study experienced a reduction in seizure frequency, and 58% reported improvements in school attendance. Emergency department visits decreased by over 50%, and significant improvements in parent proxy-report of depression and HRQoL were observed. CONCLUSIONS Results provide valuable information regarding the clinical profiles of youth with PNES and demonstrate the possibility for improved medical and psychosocial prognoses in response to psychoeducation and treatment guidance. Information obtained in this study may aid in the design of future clinical trials and research, assisting in the development of appropriate interventions.
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Affiliation(s)
- Kassie D Flewelling
- University of Colorado Denver Department of Psychology, Campus Box 173, PO Box 173364, Denver, CO, 80217-3364, United States of America; Children's Hospital Colorado, 13123 E 16th Ave., Aurora, CO 80045, United States of America.
| | - Angelina Koehler
- Children's Hospital Colorado, 13123 E 16th Ave., Aurora, CO 80045, United States of America
| | - Jonathan Shaffer
- University of Colorado Denver Department of Psychology, Campus Box 173, PO Box 173364, Denver, CO, 80217-3364, United States of America
| | - Edward J Dill
- University of Colorado Denver Department of Psychology, Campus Box 173, PO Box 173364, Denver, CO, 80217-3364, United States of America
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Abstract
The current study, based on a survey of 1799 parents, explored parental perspectives of school absence in relation to approved grades, challenges, demands and obstacles in education for children with autism spectrum disorder. The results revealed a relatively high rate of school absenteeism for reasons other than illness. Girls had higher rates of absenteeism than boys for short durations of absence. Absenteeism was primarily caused by a lack of teacher competence regarding autism and inadequate adaptation of teaching. There were no significant differences between genders in approved grades, but the rate of failure to achieve approved grades was approximately 50%. The most common form of educational support was support from special needs teachers and adapted pedagogy.
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Kang-Yi CD, Wolk CB, Locke J, Beidas RS, Lareef I, Pisciella AE, Lim S, Evans AC, Mandell DS. Impact of school-based and out-of-school mental health services on reducing school absence and school suspension among children with psychiatric disorders. Eval Program Plann 2018; 67:105-112. [PMID: 29289924 PMCID: PMC5835186 DOI: 10.1016/j.evalprogplan.2017.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 12/07/2017] [Accepted: 12/19/2017] [Indexed: 05/08/2023]
Affiliation(s)
- Christina D Kang-Yi
- Center Mental Health Policy and Services Research, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
| | - Courtney Benjamin Wolk
- Center Mental Health Policy and Services Research, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
| | - Jill Locke
- Speech and Hearing Sciences, University of Washington, Box 354875, 1417 NE 42nd St., Seattle, WA 98105, USA.
| | - Rinad S Beidas
- Center Mental Health Policy and Services Research, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
| | - Ishara Lareef
- Dartmouth College Geisel School of Medicine, 1 Rope Ferry Rd, Hanover, NH 03755, USA.
| | - Aelesia E Pisciella
- Community Behavioral Health, 801 Market Street, 7th Floor, Philadelphia, PA 19107, USA.
| | - Suet Lim
- Community Behavioral Health, 801 Market Street, 7th Floor, Philadelphia, PA 19107, USA.
| | - Arthur C Evans
- American Psychological Association, 750 First Street, NE, Washington, DC 20002, USA
| | - David S Mandell
- Center Mental Health Policy and Services Research, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
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Al-Jefout M, Seham AF, Jameel H, Randa AQ, Ola AM, Oday AM, Luscombe G. Dysmenorrhea: Prevalence and Impact on Quality of Life among Young Adult Jordanian Females. J Pediatr Adolesc Gynecol 2015; 28:173-85. [PMID: 26046607 DOI: 10.1016/j.jpag.2014.07.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/28/2014] [Accepted: 07/09/2014] [Indexed: 01/23/2023]
Abstract
STUDY OBJECTIVE To establish the prevalence and impact on quality of life of dysmenorrhea among young adult Jordanian females. DESIGN Cross-sectional study based on quantitative self-reported anonymous questionnaire. SETTING University-based study. PARTICIPANTS A total of 272 female medical students (aged 19-25 years). INTERVENTION None. MAIN OUTCOME MEASURES Self-reports of menstruation-related pain symptoms and methods of dealing with them. RESULTS Of study subjects 152/272 (55.8%) participants had moderate and severe dysmenorrhea. Of them, 55.8% had a family history of severe dysmenorrhea compared with 33.1% of those without dysmenorrhea (χ2 = 13.40, df = 1, P < .001). There was strong association between severity of dysmenorrhea and poor university attendance (χ(2) = 45.35, df = 2, P < .001), poor social activities (χ2 = 32.06, df = 2, P < .001), poor relationships with family (χ2 = 18.46, df = 2, P < .001) and friends (χ2 = 19.14, df = 2, P < .001), and poor sport activities (χ2 = 12.15, df = 2, P = .002). Dysmenorrhea worsens during examination periods in 50% of cases. The most common pain symptom was low back pain (60.2%). Body mass index, family monthly income and early age at menarche had no correlation with the occurrence of dysmenorrhea. Of those with dysmenorrhea, 69.4% were using analgesics. Mothers were the main source of information regarding menstruation. CONCLUSIONS Dysmenorrhea is highly prevalent among young adult Jordanian females and seems to negatively affect quality of life, particularly as related to university attendance and performance and social relationships.
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Affiliation(s)
- Moamar Al-Jefout
- Department of Obstetrics & Gynecology, Mutah Medical Faculty, Mutah University, Karak, Jordan.
| | - Abu-Fraijeh Seham
- Department of Obstetrics & Gynecology, Mutah Medical Faculty, Mutah University, Karak, Jordan
| | - Hijazeen Jameel
- Department of Obstetrics & Gynecology, Mutah Medical Faculty, Mutah University, Karak, Jordan
| | - Al-Qaisi Randa
- Department of Obstetrics & Gynecology, Mutah Medical Faculty, Mutah University, Karak, Jordan
| | - Al-Ma'aitah Ola
- Department of Obstetrics & Gynecology, Mutah Medical Faculty, Mutah University, Karak, Jordan
| | - Al-Ma'aitah Oday
- Department of Obstetrics & Gynecology, Mutah Medical Faculty, Mutah University, Karak, Jordan
| | - Georgina Luscombe
- Queen Elizabeth II Research Institute for Mother and Infants, Department of Obstetrics & Gynecology, Sydney University, Sydney, Australia
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Al-Dawood KM. School boys with bronchial asthma in Al-khobar city, saudi arabia: are they at increased risk of school absenteeism? J Family Community Med 2001; 8:25-33. [PMID: 23008641 PMCID: PMC3437057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The objective of this cross-sectional study was to determine the mean period of school absenteeism (MPSA) among Questionnaire Diagnosed Asthmatic (QDA) Saudi schoolboys of Al-Khobar city and the factors associated with it. METHODS The methodology of this cross-sectional study included the distribution of a self-administered questionnaire, which was completed by the parents of 1482 schoolboys who satisfied the selection criteria of the study. RESULTS The prevalence rate of QDA was 9.5% (141/1482). MPSA among Questionnaire Diagnosed Asthmatic Boys (QDAs) was 13.6 ± 3.4 days compared to 3.7 ± 2.2 days among non-QDA boys (non-QDAs). Among QDAs, it was associated significantly and positively with those who were younger, with a decreasing level of socioeconomic class, history of pets at home, presence of a current smoker in the family (father or both parents), visit to a hospital emergency room, and admission to hospital. It was significantly and negatively associated with concomitant use of prophylactic medication(s), including those used appropriately. QDAs from middle and lower socioeconomic classes used less prophylactic medication(s) but had had more visits to an emergency room and had admissions to hospital. The multiple linear regression equation for the total period of school absenteeism (TPSA) during the current academic year was generated. CONCLUSIONS QDAs have higher MPSA compared to their non-asthmatic classmates. The impact of this disease increases particularly among QDAs belonging to lower socioeconomic families.
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Affiliation(s)
- K M Al-Dawood
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
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