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The impact of chronic hemophilic arthropathy on children school life

Mohammed Amine Mahdi; Hanan Rkain; Maria Rkain; Ilham Bouaddi; Fadoua Allali; Mohammed El Khorassani; Najia Hajjaj-Hassouni.

Abstract
Objective
The purpose of this study was to assess the impact of chronic hemophilic arthropathy on Moroccan children's school life.
Methods
Twenty-five boys suffering from Hemophilia were consecutively recruited in this study. All patients have at least one joint affected by chronic hemophilic arthropathy. Demographics and characteristics of disease were recorded. Children were asked about their scholarship and perceptions about their entourage at school.
Results
Ninety-six percent of patients were at school. While 4% had to stop their schooling. A year of schooling was repeated by 36% of patients. Ninety-two percent of parents have informed the class teacher about their child disease. Schoolmates were aware of risk of bleeding in hemophilic patients in 76% of cases. Children expressed many difficulties in their daily living at school: verbal violence and discrimination reaction from colleagues and integration difficulties at classroom in respectively 52%, 12% and 32% of cases. Difficulties at walking to school were reported by 48% of patients. Three patients were also embarrassed by difficulties at writing. Absenteeism was reported in all patients and was exceeding one month over the previous academic year in 56% of cases. Only 3 children have received courses during their hospitalizations. The binary regression analysis revealed a significant relationship between absenteeism and quality of life (β=17; CI95%[1.14-1.80]; p=0.03).
Conclusion
This study highlights a neglected aspect of hemophilia consequences in our context of a developing country. Medical professionals, community and educators are encouraged to fully understand the parameters of this problematic school absenteeism to develop better policies to manage it.

Key words: schooling;children;chronic hemophilic arthropathy



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