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. 2011 Dec 12;1(2):e000252.
doi: 10.1136/bmjopen-2011-000252. Print 2011.

Unidentified Chronic Fatigue Syndrome/myalgic encephalomyelitis (CFS/ME) is a major cause of school absence: surveillance outcomes from school-based clinics

Esther M Crawley  1 , Alan M Emond, Jonathan A C Sterne
Affiliations

Unidentified Chronic Fatigue Syndrome/myalgic encephalomyelitis (CFS/ME) is a major cause of school absence: surveillance outcomes from school-based clinics

Esther M Crawley et al. BMJ Open. .

Erratum in

Abstract

Objective To investigate the feasibility of conducting clinics for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in schools. Design School-based clinical project. Participants Children aged 11-16 years were enrolled in three state secondary schools in England. Main outcome measures Number of children newly diagnosed as having CFS/ME. Methods Attendance officers identified children missing ≥20% of school in a 6-week term without a known cause, excluding those with a single episode off school, a known medical illness explaining the absence or known to be truanting. Children with fatigue were referred to a specialist CFS/ME service for further assessment. The authors compared children with CFS/ME identified through school-based clinics with those referred via health services. Outcomes of CFS/ME were evaluated at 6 weeks and 6 months. Results 461 of the 2855 enrolled children had missed ≥20% school over a 6-week period. In 315, of whom three had CFS/ME, the reason for absence was known. 112 of the 146 children with unexplained absence attended clinical review at school; two had been previously diagnosed as having CFS/ME and 42 were referred on to a specialist clinic, where 23 were newly diagnosed as having CFS/ME. Therefore, 28 of the 2855 (1.0%) children had CFS/ME. Children with CFS/ME identified through surveillance had been ill for an amount of time comparable to those referred via health services but had less fatigue (mean difference 4.4, 95% CI 2.2 to 6.6), less disability (mean difference -5.7, 95% CI -7.9 to -3.5) and fewer symptoms (mean difference 1.86, 95% CI 0.8 to 2.93). Of 19 children followed up, six had fully recovered at 6 weeks and a further six at 6 months. Conclusions Chronic fatigue is an important cause of unexplained absence from school. Children diagnosed through school-based clinics are less severely affected than those referred to specialist services and appear to make rapid progress when they access treatment.

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Conflict of interest statement

Competing interests: The authors declare that (1) EMC, AME and JACS did not receive any financial support from companies for the submitted work; (2) EMC, AME and JACS have no relationships with any companies that might have an interest in the submitted work in the previous 3 years; (3) their spouses, partners or children have no financial relationships that may be relevant to the submitted work and (4) AME and JACS have no non-financial interest that may be relevant to the submitted work. EMC is a medical advisor for the Association for Young people with ME (AYME).

Figures

Figure 1
Figure 1
Flow of children through study. *Attendance <80% for at least 6 weeks in any term over three terms. CFS/ME, chronic fatigue syndrome.
See this image and copyright information in PMC

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