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Silent cerebral infarction, income, and grade retention among students with sickle cell anemia

Silent cerebral infarction, income, and grade retention among students with sickle cell anemia
Silent cerebral infarction, income, and grade retention among students with sickle cell anemia

Children with sickle cell anemia have a higher-than-expected prevalence of poor educational attainment. We test two key hypotheses about educational attainment among students with sickle cell anemia, as measured by grade retention and use of special education services: (1) lower household per capita income is associated with lower educational attainment; (2) the presence of a silent cerebral infarct is associated with lower educational attainment. We conducted a multicenter, cross-sectional study of cases from 22 U.S. sites included in the Silent Infarct Transfusion Trial. During screening, parents completed a questionnaire that included sociodemographic information and details of their child's academic status. Of 835 students, 670 were evaluable; 536 had data on all covariates and were used for analysis. The students' mean age was 9.4 years (range: 5-15) with 52.2% male; 17.5% of students were retained one grade level and 18.3% received special education services. A multiple variable logistic regression model identified that lower household per capita income (odds ratio [OR] of quartile 1 = 6.36, OR of quartile 2 = 4.7, OR of quartile 3 = 3.87; P = 0.001 for linear trend), age (OR = 1.3; P < 0.001), and male gender (OR, 2.2; P = 0.001) were associated with grade retention; silent cerebral infarct (P = 0.31) and painful episodes (P = 0.60) were not. Among students with sickle cell anemia, household per capita income is associated with grade retention, whereas the presence of a silent cerebral infarct is not. Future educational interventions will need to address both the medical and socioeconomic issues that affect students with sickle cell anemia.

Adolescent, Anemia, Sickle Cell, Cerebral Infarction, Child, Child, Preschool, Cross-Sectional Studies, Educational Status, Humans, Male, Models, Biological, United States, Clinical Trial, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural
0361-8609
E188-192
King, Allison A.
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Rodeghier, Mark J.
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Panepinto, Julie Ann
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Strouse, John J.
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Casella, James F.
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Quinn, Charles T.
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Dowling, Michael M.
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Sarnaik, Sharada A.
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Thompson, Alexis A.
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Woods, Gerald M.
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Minniti, Caterina P.
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Redding-Lallinger, Rupa C.
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Kirby-Allen, Melanie
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Kirkham, Fenella J.
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McKinstry, Robert
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Noetzel, Michael J.
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White, Desiree A.
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Kwiatkowski, Janet K.
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Howard, Thomas H.
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Kalinyak, Karen A.
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Inusa, Baba
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Rhodes, Melissa M.
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Heiny, Mark E.
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Fuh, Ben
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Fixler, Jason M.
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Gordon, Mae O.
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DeBaun, Michael R.
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King, Allison A.
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Rodeghier, Mark J.
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Panepinto, Julie Ann
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Strouse, John J.
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Casella, James F.
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Quinn, Charles T.
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Dowling, Michael M.
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Sarnaik, Sharada A.
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Thompson, Alexis A.
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Woods, Gerald M.
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Minniti, Caterina P.
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Redding-Lallinger, Rupa C.
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Kirby-Allen, Melanie
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Kirkham, Fenella J.
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McKinstry, Robert
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Noetzel, Michael J.
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White, Desiree A.
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Kwiatkowski, Janet K.
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Howard, Thomas H.
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Kalinyak, Karen A.
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Inusa, Baba
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Rhodes, Melissa M.
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Heiny, Mark E.
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Fuh, Ben
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Fixler, Jason M.
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Gordon, Mae O.
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DeBaun, Michael R.
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King, Allison A., Rodeghier, Mark J., Panepinto, Julie Ann, Strouse, John J., Casella, James F., Quinn, Charles T., Dowling, Michael M., Sarnaik, Sharada A., Thompson, Alexis A., Woods, Gerald M., Minniti, Caterina P., Redding-Lallinger, Rupa C., Kirby-Allen, Melanie, Kirkham, Fenella J., McKinstry, Robert, Noetzel, Michael J., White, Desiree A., Kwiatkowski, Janet K., Howard, Thomas H., Kalinyak, Karen A., Inusa, Baba, Rhodes, Melissa M., Heiny, Mark E., Fuh, Ben, Fixler, Jason M., Gordon, Mae O. and DeBaun, Michael R. (2014) Silent cerebral infarction, income, and grade retention among students with sickle cell anemia. American Journal of Hematology, 89 (10), E188-192. (doi:10.1002/ajh.23805).

Record type: Article

Abstract

Children with sickle cell anemia have a higher-than-expected prevalence of poor educational attainment. We test two key hypotheses about educational attainment among students with sickle cell anemia, as measured by grade retention and use of special education services: (1) lower household per capita income is associated with lower educational attainment; (2) the presence of a silent cerebral infarct is associated with lower educational attainment. We conducted a multicenter, cross-sectional study of cases from 22 U.S. sites included in the Silent Infarct Transfusion Trial. During screening, parents completed a questionnaire that included sociodemographic information and details of their child's academic status. Of 835 students, 670 were evaluable; 536 had data on all covariates and were used for analysis. The students' mean age was 9.4 years (range: 5-15) with 52.2% male; 17.5% of students were retained one grade level and 18.3% received special education services. A multiple variable logistic regression model identified that lower household per capita income (odds ratio [OR] of quartile 1 = 6.36, OR of quartile 2 = 4.7, OR of quartile 3 = 3.87; P = 0.001 for linear trend), age (OR = 1.3; P < 0.001), and male gender (OR, 2.2; P = 0.001) were associated with grade retention; silent cerebral infarct (P = 0.31) and painful episodes (P = 0.60) were not. Among students with sickle cell anemia, household per capita income is associated with grade retention, whereas the presence of a silent cerebral infarct is not. Future educational interventions will need to address both the medical and socioeconomic issues that affect students with sickle cell anemia.

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More information

Accepted/In Press date: 11 July 2014
e-pub ahead of print date: 15 July 2014
Published date: October 2014
Additional Information: © 2014 Wiley Periodicals, Inc.
Keywords: Adolescent, Anemia, Sickle Cell, Cerebral Infarction, Child, Child, Preschool, Cross-Sectional Studies, Educational Status, Humans, Male, Models, Biological, United States, Clinical Trial, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural

Identifiers

Local EPrints ID: 419542
URI: https://eprints.soton.ac.uk/id/eprint/419542
ISSN: 0361-8609
PURE UUID: 3d6aabd0-5975-4421-be72-406d68e51a57
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 13 Apr 2018 16:30
Last modified: 13 Jun 2019 00:37

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Contributors

Author: Allison A. King
Author: Mark J. Rodeghier
Author: Julie Ann Panepinto
Author: John J. Strouse
Author: James F. Casella
Author: Charles T. Quinn
Author: Michael M. Dowling
Author: Sharada A. Sarnaik
Author: Alexis A. Thompson
Author: Gerald M. Woods
Author: Caterina P. Minniti
Author: Rupa C. Redding-Lallinger
Author: Melanie Kirby-Allen
Author: Fenella J. Kirkham ORCID iD
Author: Robert McKinstry
Author: Michael J. Noetzel
Author: Desiree A. White
Author: Janet K. Kwiatkowski
Author: Thomas H. Howard
Author: Karen A. Kalinyak
Author: Baba Inusa
Author: Melissa M. Rhodes
Author: Mark E. Heiny
Author: Ben Fuh
Author: Jason M. Fixler
Author: Mae O. Gordon
Author: Michael R. DeBaun

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