School Functioning Activity of Bengali Thalassemic Children Attending a Tertiary Care Hospital of Eastern India

Document Type : Original Article


1 Department of Community Medicine, Bankura Sammilani Medical College, Bankura, West Bengal, India

2 Department of Community Medicine, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Community Medicine, Kolkata, West Bengal, India

3 Department of Community Medicine, IQ City Narayanahrudayala Hospital & Medical College, Durgapur, West Bengal, India


Introduction: The study was conducted to assess the school activity of thalassemic children and to reveal the relationship between school activity with the socio-demographic factors as well as clinico-therapeutic profile.
Methods: A total of 365 admitted thalassemic patients of Burdwan Medical College (ages 5 to 12 years) were participated in this cross sectional descriptive study conducted on from July 2011 to June 2012. Their parents were interviewed using school functioning domain of Paediatric Quality of Life Inventory 4.0 Generic Core Scale. Independent t test or Mann-Whitney U test, and analysis of variance (ANOVA) or Kruskal-Wallis test were applied to observe the difference between mean values in accordance to their applicability. Statistically significant factors in bivariate analysis were considered for binary logistic regression.
Results: Mean score of school activity was 49.42 ± 15.30 out of 100. 49.3% thalassemic children had fair (50-74.9) school functioning score. Twenty percent of the children were presently not going to school, 11.8% never went to school and the remaining 8.2% were dropped out. Binary logistic regressions revealed that school activity worsened 4 times with the increase in frequency of blood transfusion single time per year. Patients belonging to joint family and family with no positive history of such disease, had 3.4 and 3.9 times worse school activity than nuclear family and family with positive child history respectively. Male children had 2 times more poor school activity than female.
Conclusion: School functioning activity of Bengali thalassemic children is generally poor, but counselling of parents and families can improve the situation.


  1. Weatherall DJ, Clegg JB. The thalassaemia syndromes. John Wiley & Sons; 2008.
  2. Yaish HM, Johnston JM, Harper JL, Chan H, Coppes MX. Pediatric Thalassemia. Medscape website. article/958850-overview. Updated Octtober 11, 2015.
  3. Verma IC, Choudhry VP, Jain PK. Prevention of thalassemia: a necessity in India. Indian J Pediatr. 1992;59(6):649-654. doi:10.1007/BF02859390
  4. Forrest CB, Simpson L, Clancy C. Child health services research: challenges and opportunities. JAMA. 1997;277(22):1787-1793. doi:10.1001/jama.1997.03540460051032
  5. Homer CJ, Kleinman LC, Goldman D. Improving the quality of care for children in health systems. Health Serv Res. 1998;33(4 Pt 2):1091.
  6. McGlynn EA, Halfon N, Leibowitz A. Assessing the quality of care for children: prospects under health reform. Arch Pediatr Adolesc Med. 1995;149(4):359-368. doi:10.1001/archpedi.1995.02170160013002
  7. Seid M, Varni JW, Segall D, Kurtin PS. Health-related quality of life as a predictor of pediatric healthcare costs: a two-year prospective cohort analysis. Health Qual Life Outcomes. 2004;2(1):1. doi: 10.1186/1477-7525-2-48
  8. Bala J, Sarin J. Empowering parents of children with thalassemia. Int J Nurs Care. 2014;2(1):22. doi:10.5958/j.2320-8651.2.1.005
  9. Singh K, Singh K, Singh R, Kaur D. Financial burden on the families of transfusion dependent thalassemic children. Pediatr Oncall J. 2013;10(1). doi:10.7199/ped.oncall.2013.2
  10. Thavorncharoensap M, Torcharus K, Nuchprayoon I, Riewpaiboon A, Indaratna K, Ubol BO. Factors affecting health-related quality of life in Thai children with thalassemia. BMC Hematol. 2010;10:1. doi:10.1186/1471-2326-10-1
  11. Torcharus K, Pankaew T. Health-related quality of life in thalassemia treated with iron chelation. Royal Thai Army Med J. 2011;64:3-10.
  12. El Dakhakhny AM, Hesham MA, Mohamed SE, Mohammad FN. Quality of life of school age thalassemic children at Zagazig city. J Am Sci. 2011;7(1):186-197.
  13. Guha P, Talukdar A, De A, Bhattacharya R, Pal S, Dasgupta G. Behavioral profile and school performance of thalassemia children in Eastern India. Asian J Pharm Clin Res. 2013;6(2):49-52.
  14. Varni J. The PedsQL™ 4.0 measurement model for the Pediatric Quality of Life Inventory™ version 4.0: Administration guidelines. 2004.
  15. Lal S, Adarsh P. Textbook of Community Medicine. Delhi: CBS Publishers and Distributors; 2010.
  16. Ismail A, Campbell MJ, Ibrahim HM, Jones GL. Health related quality of life in Malaysian children with thalassaemia. Health Qual Life Outcomes. 2006;4(1):39. doi:10.1186/1477-7525-4-39
  17. Cheuk D, Mok A, Lee A, et al. Quality of life in patients with transfusion-dependent thalassemia after hematopoietic SCT. Bone Marrow Transplant. 2008;42(5):319-327. doi:10.1038/ bmt.2008.165
  18. Weatherall D. Keynote address: The challenge of thalassemia for the developing countries. Ann N Y Acad Sci. 2005;1054(1):11-17. doi:10.1196/annals.1345.002
  19. TNS. Survey for assessment of dropout rates at elementary level in 21 states India. 2013. Accessed 24 January 24, 2015.
  20. Ayoub MD, Radi SA, Azab AM, et al. Quality of life among children with beta-thalassemia major treated in Western Saudi Arabia. Saudi Med J. 2013;34(12):1281-1286.
  21. Borhani F, Kargar Najafi M, Rabori ED, Sabzevari S. The effect of family-centered empowerment model on quality of life of school– aged children with thalassemia major. Iran J Nurs Midwifery Res. 2011;16(4):292–298.
  22. Allahyari I, Alhani F, Kazemnezhad A, Izadyar M. The effect of family empowerment model-based on the quality of life of school-age children with thalassemia. Iran J Pediatr. 2006;4:455-461.
Volume 4, Issue 3 - Serial Number 14
September 2016
Pages 82-87
  • Receive Date: 26 March 2016
  • Revise Date: 13 April 2016
  • Accept Date: 18 April 2016
  • First Publish Date: 01 September 2016