Impact of Biosocial Factors on the Neuro-Cognitive Functions of School Children with Sickle Cell Anaemia

Abstract

Background: Sickle cell anaemia (SCA) may impair attention, memory, intelligence and academic performance.  This  study  assessed  cognitive function (academic performance and intelligent quotients, (IQ) of children with SCA and determined association between biosocial factors and neurocognition.

Materials and Methods: Cognitive function of 120 children with SCA and 104 matched controls was assessed with Ziler's Draw-A-Person test, academic performance questionnaire (APQ) and average annual academic report. Association with disease 
severity, sociodemographic, nutritional and clinico-haematological  factors  was  assessed using multivariate analyses.

Results: More controls than subjects obtained high scores in the APQ, p=0.003. The mean annual academic score was also higher in the controls, p=0.028. However, there was no difference in their mean IQ scores, p=0.831. Disease severity scores, duration of school absenteeism,  age  and  class  of  SCA  children had negative correlation with average annual academic  scores  (p=0.004,  0.009,  0.031  and 0.038 respectively). IQ scores however positively correlated with average annual scores, p=0.007. Sex distribution, social class, nutritional status and haematological data had no influence on academic performance or IQ. Although, school absenteeism (OR=4.1, 95%CI =2.2–8.4,  p=0.003)  and  IQ  (OR=2.9,  95%CI =1.3–7.7, p=0.024) independently predicted academic  performance,  none  of  the  factors predicted IQ.

Conclusion: Children with SCA had poorer academic performance, although their IQs were comparable to controls. Age, school type, class, disease severity and duration of school absenteeism  influences  cognition  of  children with SCA.