Young people put off life decisions, delaying education, marriage, childbearing.
Inability to work or study was recorded as sickness absence certified by a doctor or delayed education [ 28].
Out of school Reports suggest that the extended period of school closures has had a negative impact on children, and not just in terms of delayed education.
In the statistical analyses number of treatment courses, treatment refractory infection, delayed education and sick leave were used as indices of protracted and severe Giardia infection.
Particularly those reporting ">1 semester delayed education", but also "sick leave > 2 weeks", could potentially be cases actually reporting persistent symptoms, but excluding them from the statistical analyses would have created a selection bias.
Likelihood-ratio test (STATA) More than one course of treatment for giardiasis, as well as delayed education, was significantly associated with both fatigue and abdominal symptoms in all analyses.
Patients who reported persistent fatigue, lowered functional capacity and sickness leave or delayed education after a large community outbreak of giardiasis enteritis in the city of Bergen, Norway were evaluated with the established Centers for Disease Control and Prevention criteria for CFS.
More than one treatment course, delayed education, sick leave more than 2 weeks, and malaise at the time of infection, were significantly associated with fatigue in the multiple regression analysis, as were increasing age and previous abdominal problems.
Factors in multiple regression analysis significantly associated with abdominal symptoms two years after infection were: More than one treatment course, treatment refractory infection, delayed education, bloating and female gender.
Patients with loss of employment or delayed education due to severe fatigue were admitted to a specialist chronic fatigue clinic at the Department of Neurology, Haukeland University Hospital, Bergen, Norway for clinical evaluation with Centers for Disease Control and Prevention CDCcriteriaria [ 9- 11].
A possible weakness in our definition of indices of protracted and severe Giardia infection is that sick leave or delayed education may be signs of PI-IBS or fatigue rather than protracted infection or inflammation.
