School performance of children with sickle cell disease in Basra, Iraq

BACKGROUND: Children with sickle cell disease (SCD) have a greater likelihood of demonstrating many medical complications that may put them at risk for a variety of difficulties, including poor school performance and cognitive impairment. OBJECTIVES: This study was designed to assess the school performance of primary school-aged patients with SCD compared to age- and gender-matched healthy students and to evaluate the factors that influence school performance in these patients. MATERIALS AND METHODS: A total of 68 patients with SCD from 48 primary schools and 68 healthy student classmates (control group), aged 7–12 years, were recruited. The average school examination scores were used as a school performance measure, while cognitive functioning was assessed by using the Draw-A-Person test. RESULTS: The average school examination scores and cognitive function scores of patients with SCD (82.46 ± 15.48 and 24.72 ± 7.48, respectively) were significantly lower than the corresponding scores of their classmate control group (93.42 ± 10.02 and 27.84 ± 7.46, respectively), P < 0.05. Students with SCD missed significantly more school days (12.37 ± 10.57) than healthy students (3.18 ± 3.62), P < 0.001, and high school absence was significantly associated with low school performance among SCD patients, P = 0.027. Among patients with SCD, Pearson correlation revealed a negative association between school performance and age and school absence days (r = −0.346 and r = −0.390, respectively, P < 0.01) and a positive association between school performance and maternal education (r = −0.388, P < 0.001). CONCLUSIONS: School performance and cognitive function were significantly lower among patients with SCD than among their classmates, and school absence and the age of patients had a negative impact on school performance