Infectious morbidity and white blood cell count associated withgrade repetition and school absenteeism

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dc.contributor.authorVillamor, Eduardo
dc.contributor.authorBeer, Rachael J.
dc.contributor.authorSeeley, Allison L.
dc.contributor.authorLópez-Arana, Sandra
dc.contributor.authorMarín, Constanza
dc.contributor.authorMora-Plazas, Mercedes
dc.date.accessioned2025-08-27T13:48:55Z
dc.date.available2025-08-27T13:48:55Z
dc.date.issued2024-11-14
dc.description.abstractAim: Infections can impair cognitive development, but their role on adverse childhoodeducational outcomes is unknown. We examined the associations of infectious mor-bidity and inflammatory biomarkers with grade repetition and school absenteeism.Methods: We followed 2762 Colombian children aged 5–12 years for a school year.We quantified inflammatory biomarkers at enrolment and prospectively recorded in-cidence of gastrointestinal and respiratory infections, doctor visits and absent daysfrom school using pictorial diaries. We estimated adjusted relative risks (ARR) with95% confidence intervals (CI) for grade repetition and absenteeism by infectious mor-bidity burden and inflammatory biomarker categories, and percentages of the asso-ciations mediated through absenteeism.Results: Morbidity was associated with increased risk of grade repetition. ARR (95%CI) of grade repetition comparing high versus no incidence of gastrointestinal, res-piratory and ear infections were, respectively, 2.17 (1.00, 4.72), 2.31 (1.28, 4.16) and2.57 (1.13, 5.86). Infections also predicted school absenteeism, which mediated 35%,31% and 38% of the corresponding morbidity-grade repetition associations. Elevatedwhite blood cells (WBC), especially granulocytes, were related to increased grade rep-etition and school absenteeism risks.Conclusion: Childhood infections and elevated WBC are associated with grade repeti-tion and school absenteeism. Absenteeism does not fully explain the morbidity-graderepetition associations.
dc.identifier.citationActa Paediatrica: Nurturing the child, Vol. 114, N° 5 (2025) p. 954–963.
dc.identifier.doihttps://doi.org/10.1111/apa.17513
dc.identifier.issn0803-5253
dc.identifier.issne1651-2227
dc.identifier.orcidhttp://orcid.org/0000-0002-4312-1318
dc.identifier.urihttps://hdl.handle.net/20.500.12254/4282
dc.language.isoen
dc.publisherWiley
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectChildhood infections
dc.subjectGastrointestinal morbidity
dc.subjectGrade repetition
dc.subjectGrade retention
dc.subjectGranulocytes
dc.subjectRespiratory infection
dc.subjectSchool absenteeism
dc.subjectWhite blood cells
dc.titleInfectious morbidity and white blood cell count associated withgrade repetition and school absenteeism
dc.typeArticle
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