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Prevalence of transcranial Doppler abnormalities in Nigerian children with sickle cell disease
IkeOluwa Lagunju1, Olugbemiro Sodeinde, Paul Telfer
1Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria. ilagunju@yahoo.co.uk
Insights
Transcranial Doppler (TCD) ultrasonography identifies stroke risk in children with sickle cell disease (SCD). Nigerian children with SCD show a higher prevalence of conditional risk velocities compared to African-American children.
Area of Science:
- Neurology
- Pediatrics
- Hematology
Background:
- Sickle cell disease (SCD) poses a significant stroke risk in children.
- Early identification of at-risk individuals is crucial for primary stroke prevention.
- Transcranial Doppler (TCD) ultrasonography is a key tool for assessing cerebral blood flow (CBF) in pediatric SCD.
Purpose of the Study:
- To describe the pattern of cerebral blood flow (CBF) abnormalities in Nigerian children with SCD.
- To evaluate the prevalence of abnormal and conditional risk (CR) velocities in different SCD genotypes.
- To compare CBF velocities in Nigerian children with SCD to those in African-American children.
Main Methods:
- A cross-sectional study involving 145 Nigerian children aged ≥3 years with SCD.
- Utilized Transcranial Doppler (TCD) ultrasonography to measure time-averaged mean velocity (TAMV).
- Analyzed data based on SCD genotype (Hb SS and Hb S1C) and age.
Main Results:
- Mean TAMV was higher in Hb SS (152 ±27.0 cm/sec) than Hb S1C (122 ±22.0 cm/sec) groups.
- Abnormal velocities were found in 4.7% of Hb SS patients; CR velocities in 19.7% of Hb SS and 5.6% of Hb S1C.
- Cerebral flow velocities negatively correlated with age and hematocrit.
Conclusions:
- Nigerian children with Hb SS disease exhibit a higher prevalence of CR velocities compared to African-American children.
- TCD is effective in identifying stroke risk in pediatric SCD patients.
- Findings highlight the need for targeted stroke prevention strategies in this population.
Abstract:
Transcranial Doppler (TCD) ultrasonography helps to identify children with sickle cell disease (SCD) who are at an increased risk of stroke,making primary stroke prevention a reality. A cross-sectional study of145 Nigerian children aged ≥3 years with SCD was carried out to describe the pattern of cerebral blood flow (CBF) abnormalities. The mean time-averaged mean velocity (TAMV) was 152 ±27.0 cm/sec and122 ±22.0 cm/sec in Hb SS and Hb S1C group, respectively. Abnormal velocities were recorded in six (4.7%) of the Hb SS patients and none of the Hb S1C while conditional risk (CR) velocities were recorded in 19.7% of Hb SS (low conditional 11.0%, high conditional 8.7%) and low conditional in 5.6% of Hb S1C cases. Cerebral flow velocities showed a negative correlation with age and hematocrit. Compared with African-American children, Nigerian children with Hb SS disease have a considerably higher prevalence of CR velocities.
