[Relationship between asthma or asthma-related symptoms and school problems among French children attending kindergarden].
BACKGROUND
The impact of chronic respiratory symptoms on school performance has been studied less than its impact on children's health. Our survey explored the relationship between chronic respiratory symptoms and school problems among children attending kindergarten. It assessed the impact of school absenteeism, sport practise in a club and health care access for school problems among pupils with chronic respiratory symptoms.


METHODS
A population-based study was carried out by school physicians on a representative sample of pupils attending third-year kindergarten, in Alsace - France. Assessments included school problems, sociodemographic and health care access characteristics. Health conditions, notably chronic respiratory symptoms, were asked to include the pupils in one of the three study groups: physician-diagnosed asthma, asthma-related symptoms not associated with diagnosed asthma, and without current health problems (controls). Logistic regression was used to compare the odds ratio of school problems for the three study groups, overall and stratified by income.


RESULTS
The 2,632 included pupils aged 5 to 6 Years, were assigned to the three groups according to their respiratory status: 179 with diagnosed asthma, 176 with asthma related symptoms and 2,277 healthy pupils. Diagnosed asthma was not linked with school problems. The overall association between asthma related symptoms and school problems was significant (OR=1.5, 95% CI: 1.0-2.2). After adjustment, this association persisted among pupils whose mother's education level was intermediary (technical or vocational diploma) (OR=2.3, 95% CI: 1.2-4.6). Among the diagnosed asthma group, pupils practising a sport in a club had less school problems than those not taking part in sports (ORadjusted=0.2, 95% CI: 0.03-0.8).


CONCLUSIONS
In our study, asthmatic children were not at higher risk of school problems. So developing programs preventing school problems which focus on asthmatic children is not needed. Among the pupils having a mother with an intermediary education level, asthma-related symptoms were associated with school problems. It is important to identify unknown asthmatics to institute to treatment for their respiratory symptoms in order to prevent the consequences of the functional impact of asthma on their scholarship.
Le Louarn
A
A
Mission de Promotion de la Santé en Faveur des Elèves, Inspection Académique du Bas-Rhin, 65, avenue de la Forêt-Noire, 67083 Strasbourg Cedex. anne.lelouarn@chru-strasbourg.fr
Schweitzer
B
B
D000041:Absenteeism; D000367:Age Factors; D001249:Asthma / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004493:Education; D005220:Fathers; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D009035:Mothers; D016017:Odds Ratio; D012135:Respiratory Sounds; D012574:Schools; D012737:Sex Factors; D013177:Sports; D011795:Surveys and Questionnaires