Predictors of Cerebrovascular Accident Among Sudanese Children with Sickle Cell Anemia

Area of Science:

• Neurology
• Hematology
• Pediatrics

Background:

• Sickle cell disease (SCD) is an inherited blood disorder characterized by abnormal hemoglobin.
• Neurological complications, including cerebrovascular accidents (CVA), are severe and common in SCD patients.
• Preventive measures like transcranial Doppler (TCD) screening and blood transfusions are crucial for reducing stroke risk.

Purpose of the Study:

• To evaluate the prevalence and impact of neurological complications, specifically CVA, in Sudanese children with SCD.
• To identify risk factors and predictors associated with CVA in this population.
• To highlight challenges in accessing preventive care for SCD patients in the region.

Main Methods:

• Retrospective review of medical records of SCD patients aged 2-15 years at Albuluk Children's Hospital (2017-2019).
• Exclusion of patients with other central nervous system (CNS) conditions.
• Analysis of demographic, clinical, and socioeconomic factors associated with CVA.

Main Results:

• A CVA prevalence of 11.1% was observed among 117 SCD patients.
• Risk factors identified include younger age (2-5 years), chest syndrome, severe anemia, and elevated white blood cell (WBC) counts.
• Low-moderate socioeconomic status and a positive family history were associated with 76.9% of CVA cases.
• Limited access to TCD, MRI, and regular blood transfusions presented significant barriers to care.

Conclusions:

• Stroke prevalence in SCD is significantly higher in regions with limited access to advanced preventive measures.
• Early identification of high-risk individuals and improved access to TCD, MRI, and transfusions are critical for preventing CVA in SCD.
• Targeted interventions addressing socioeconomic factors and providing comprehensive care are essential for improving outcomes in Sudanese SCD patients.