Capacity building and stroke risk assessment in Nigerian children with sickle cell anaemia

• Published in: Pediatric blood & cancer Vol. 61; no. 12; pp. 2263 - 2266
• Main Authors: Soyebi, Kofo, Adeyemo, Titilope, Ojewunmi, Oyesola, James, Funmi, Adefalujo, Kunle, Akinyanju, Olu
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-12-2014
• Subjects: Adolescent; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - physiopathology; Blood Flow Velocity; Capacity Building; cerebral blood flow velocity; Cerebrovascular Circulation; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Nigeria; Prognosis; Risk Assessment; sickle cell anaemia; Stroke - diagnosis; Stroke - etiology; Stroke - prevention & control; stroke prevention; Transcranial Doppler ultrasonography; Ultrasonography, Doppler, Transcranial - methods; Nigeria; Transcranial Doppler ultrasonography; Nigeria; cerebral blood flow velocity; stroke prevention; sickle cell anaemia
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.25216

Background
Transcranial Doppler ultrasonography (TCD) measures blood flow velocities in the large cerebral vessels and thus, detects the risk of stroke. This report describes a capacity building program which enabled the use of TCD for detecting stroke risk and also describes the pattern of non‐imaging TCD examinations seen in Nigerian children with sickle cell anaemia (SCA).
Procedure
Ten university graduates were trained on the use of TCD in a 5‐day capacity building workshop after which, the three best candidates were employed to provide a 5‐day a week TCD screening service in Lagos. Data from TCD examination collected between March 2011 and September 2013 were analysed and reported.
Result
Between March 2011 and September 2013, 2,331 children with SCA aged 2–16 years had TCD studies. TCD's findings were classified as normal (standard risk) in 70.4%, conditional in 19% and abnormal (high risk) in 9.3%. The majority of children (76.9%) in the high risk category were aged 2–8 years. TCD study was inadequate for risk categorisation in 1.3% of the patients.
Conclusion
Effective capacity building of middle level manpower is feasible and can provide a credible TCD screening service to communities with a high demand and a shortage of trained professionals. The pattern of TCD abnormalities seen in Africa are comparable to those obtained in several previous worldwide reports. Pediatr Blood Cancer 2014;61:2263–2266. © 2014 Wiley Periodicals, Inc.