A story in yesterday's Metro section contained incorrect information about sickle cell anemia. The sickle cell trait is not fatal; it only means that a person carries a gene for the disease. No further diagnosis is needed. If a carrier of a sickle cell gene has a child with another carrier there is a possibility that the child will have sickle cell disease, which can be fatal.
Complete medical examinations of nearly 2,500 D.C. public school students from some of the city's poorest neighborhoods have found that about 65 percent of the children need to see a doctor for treatment of ailments ranging from excessive tooth decay and wax buildup in their ears to high blood pressure, according to a report released yesterday by a committee of the D.C. school board.
The free physical examinations, aimed at poor children and conducted earlier this year at 41 elementary schools and one junior high school located near public housing projects, also uncovered several cases of poor eyesight, including one child who was blind in one eye; cases of exposure to tuberculosis, and disorders of the heart, lungs and skin.
The tests -- the first complete physicals ever given in D.C. public schools -- found 1,256 instances of tooth and gum problems, including cavities and bleeding; 363 cases of excessive earwax, which causes headaches and poor hearing; 145 cases of impaired vision, and 109 instances of poor or sickly physical appearance, according to the report.
In addition, 115 pupils had positive reactions to tests for the sickle cell anemia trait, a potentially deadly disorder, and 33 had positive reactions to a tuberculosis test.
"The known high prevalence of TB in the District of Columbia and the number of positives detected in this small population would indicate a need to offer testing to all children (in the city) regardless of ability to pay," concluded the report, which was written by the private health group that ran the testing program.
The positive reactions to the sickle cell test mean further diagnosis is needed to determine the likelihood of the trait's advancing to the critical stages of sickle cell disease, officials said.
"Our findings indicate that there are serious problems related to the health of poor children," said Leonard Harris, president of City Child Care Inc.
CCC conducted the tests, which included blood and urine samples among other procedures.
"These problems should signal to everyone that we need to make health a top priority issue in the education of children," Harris stressed.
School officials approved the $200,000 screening program last year in an effort to ensure that poor children receive adequate health care, said school board member Nate Bush, who represents Ward 7, one of the three wards where the tests were conducted.
Students in wards 2 and 8 also were examined.
"The CCC screenings presented an opportunity for many of our students to receive health checkups," Bush said. "It's a tremendous opportunity for our kids who would not otherwise receive it. Since the services are brought to them, there's a greater likelihood of parents using this service and children being [exposed] to the services."
The testing program also found 776, or 31.2 percent, of the children examined had incomplete immunization records at their schools, indicating "the schools need to monitor" more closely student health records, the report said.
It was unclear whether the excessive tooth and gum decay -- the most common ailments -- were caused by poor eating habits, poor dental hygiene or poverty, the report said. "At least one child stated that its parents could not afford toothbrushes," the report said.
"We weren't shocked with the results of the [health] screenings," said James Speights, vice president of City Child Care Inc. "We know that this population is underserviced and they don't realize the importance of periodic screenings and yearly physicals for their children. We've removed some of those barriers that have interfered with their ability to get their children to see a doctor."
The report noted that "there seems to be a concentration of medical problems in areas where there are limited numbers of private pediatricians."
Students needed written parental permission for the testing, the report said. They were examined by doctors and nurses who set up examination areas in multipurpose rooms, Speights said.
Most cities that offer free health screenings for poor families reach a higher percentage of poor children than does the District, said Lee Partridge, chief of the District's Office of Health Care Financing, which administers the Early and Periodic Screening, Diagnosis and Treatment program.
"You look across the country and get some sense of whether or not you are reaching a percentage that is comparable to other large cities," she said.
"We are on the low end. And for that reason we have been working rather aggressively to improve public information about the EPSDT program and encourage people to use it. CCC is a very important part of that effort."