title: Does school attendance during initial cancer treatment in childhood increase the risk of infection?
abstract: BACKGROUND
  The present study aimed to investigate the relationship between school attendance and infection requiring antimicrobial treatment in children undergoing treatment for cancer.
  
  
  METHODS
  A national cohort of children aged 7-16 years undergoing cancer treatment was assessed during two observation periods of 19 days each, 1 month (n = 89) and 2.5 months (n = 89) poststart of treatment. Children free from infection at start of each observation period were included. Multivariable logistic regression analyses were performed including factors potentially associated with start of antimicrobial treatment.
  
  
  RESULTS
  Twenty-seven (30%) children started antimicrobial treatment during the first observation period. Factors associated with an increased risk of starting antimicrobial treatment were diagnosed with sarcoma (OR = 24.37, P = 0.002) or non-Hodgkin lymphoma (OR = 17.57, P = 0.025), having neutropenia (OR = 5.92, P = 0.020) and age less than 13 years (OR = 8.54, P = 0.014). During the second observation period, when 20 (22%) children started antimicrobial treatment, the probability of starting treatment was increased in children with neutropenia (OR = 4.25, P = 0.007). There was no statistically significant association between starting treatment for infection and school attendance.
  
  
  CONCLUSIONS
  In this study, children attending school while undergoing cancer treatment did not run a higher risk of starting antimicrobial treatment than children absent from school. However, there is a need for further studies evaluating risk of infections in children with ongoing cancer treatment.
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. margareta.afsandeberg@karolinska.se
authors.forename: Margareta
authors.initials: M
authors.lastname: af Sandeberg
authors.forename: Lena
authors.initials: L
authors.lastname: Wettergren
authors.forename: Olle
authors.initials: O
authors.lastname: Björk
authors.forename: Johan
authors.initials: J
authors.lastname: Arvidson
authors.forename: Eva
authors.initials: E
authors.lastname: Johansson
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002648:Child; D015331:Cohort Studies; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D009503:Neutropenia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012509:Sarcoma / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D012574:Schools
chemical_list: D000890:Anti-Infective Agents