certificate and an occupation rated as senior/cleri- cal/technical cadre; two points for a senior second- ary school certificate, grade-II teacher's certificate.
A Comparative Study of Academic Achievement of Children with Sickle Cell Anemia and Their Healthy Siblings Olusoga B. Ogunfowora, FWACP; Durotoye M. Olanrewaju, FWACP; and Gregory 1. Akenzua, FRCP(C) Sagamu, Nigeria
Background: Sickle cell anemia (SCA) could impact nega-
INTRODUCTION
tively on academic performance of affected children. Reports so far have been inconsistent. Objective: To do a comparative analysis of academic performance of Nigerian children with SCA and their siblings. Methods: We studied sessional aggregate scores, pass rates and percentage scores in four core subjects (mathemafics, English language, integrated science and social studies), as well as the total number of days of school absence of 52 school-age children (6-17 years) with sickle cell anemia and 42 siblings of similar sociodemographic characteristics, over one academic session. Findings: School absence among the SCA patients was significantly higher than that of siblings (9.3 ± 5.5 days/school year and 4.3 ± 2.6 days/school year, respectively, mean ± SD, p0.5), as shown in Table 5. However, further analysis of the data revealed that 13 (25%) sicklers fell into the category of below-average pupils, compared to only two (4.8%)
siblings. The difference here was statistically significant (Table 6). On the other hand, 27 (51.9%) sicklers compared to 32 (76.2%) siblings belonged to the average category, the difference being statistically significant also. The remainders of the pupils in either group were above-average with aggregate scores above 75%. In this category, there were 12 (23.1%) sicklers and eight (19%) siblings (p>O.5). Table 7 presents the mean percentage scores of the pupils in selected core subjects, namely mathematics, English language, integrated science and social studies. In these four subjects, the mean scores of the sicklers were not significantly different from those of the siblings. Similarly, the number of pupils that passed each core subject among the sicklers was comparable to that of the siblings (Table 8).
DISCUSSION
The observation of increased school absence rates among children with SCA of both genders in the present study, compared to their siblings, does not come as a surprise. SCA is a chronic illness that is characterized by frequent exacerbations of symptoms termed crises. These crises are associated with frequent hospitalizations and interruptions of child activities and loss of school time.3',' The observation is also in agreement with earlier reports.1-3 With regard to academic performance, it was observed in the present study that the children with SCA had a mean aggregate score that compared well with that of their siblings, irrespective of sex. Secondly, there was no significant difference in the performance of both groups in the four core subjects that were reviewed. These two findings tend to suggest that Table 5. Correlafion between School Absence and Sessional Aggregate Score children with SCA are able to cope with diverse learning in P Mean (SD) of Days Mean (SD) Pearson's Correlation t School Absence Aggregate Score Coefficient r school as well as their siblings. This is, however, not the whole -0.0996 0.679 >0.5 SS 9.3 (5.5) 62.6 (15.3) picture. SIB 4.3 (2.6) -0.1217 64.8 (14.1) 0.548 >0.5 Further analysis of the data revealed that there were a significantly higher numTable 6. Grading of Academic Performance of the Study Population Based on Their Sessional Aggregate Score ber of below-average pupils in the SCA group compared SS SIB to the siblings. A similar 2 % % P Value No. No. observation was documented in our earlier report, whereby 0.64 12 8 19 0.23 Above-average 23.1 the children with SCA had a (SAS >75%) significantly larger propor0.016* 27 32 76.2 5.85 Average 51.9 tion of poor achievers than (SAS 50-75 %) age- and sex-matched healthy classmates who were 2 0.017* 4.8 5.67 Below-average 13 25 not of the same blood.'2 This (SAS
