Stroke risk assessment in children with sickle cell disease using transcranial Doppler ultrasound in Cameroon.

The majority of children with sickle cell disease had normal cerebral arterial velocities, while a minority showed intermediate or high velocities indicating elevated stroke risk.

• Among 110 participants, 79.1% had normal arterial velocities, 12.7% had intermediate velocities, and 8.2% had high velocities
• High velocities indicate elevated stroke risk per STOP trial criteria
• Mean age of participants was 8.35 ± 3.74 years
• Children aged 2-16 years with confirmed sickle cell disease were evaluated across three hospitals in Cameroon (Buea, Limbe, and Laquintinie Hospitals)

Acute chest infections were significantly associated with high cerebral artery velocities in children with sickle cell disease.

• Statistical significance was set at p<0.05
• Analysis included bivariate and multivariate methods using SPSS v23.0
• The association was described as potentially significant, suggesting acute chest infections may exacerbate stroke risk

Prophylactic vaccination with meningococcal and pneumococcal vaccines appeared to be protective against high cerebral artery velocities.

• Immunization status was among the data collected for analysis
• Both meningococcal and pneumococcal vaccinations were specifically identified as potentially protective
• The protective association was identified through bivariate and multivariate statistical analysis

Transcranial Doppler ultrasound was used to measure cerebral blood flow velocities using time-averaged mean maximum velocity and peak systolic velocity in the middle cerebral and distal internal carotid arteries.

• Stroke risk was classified per the STOP (Stroke Prevention Trial in Sickle Cell Anemia) trial criteria
• Data collected included demographics, clinical history, immunization status, and hematological parameters in addition to cerebral blood flow velocities
• The study was cross-sectional, conducted from January to April 2024
• The study was conducted in three hospitals in Cameroon representing a resource-limited setting

Transcranial Doppler is identified as a valuable tool for early stroke risk stratification in pediatric sickle cell disease populations in resource-limited settings.

• The tool is described as a validated instrument for stroke risk prediction in sickle cell disease
• The study demonstrates feasibility of TCD use in three Cameroonian hospitals
• TCD enables timely preventive interventions by identifying children at elevated stroke risk
• The study population of 110 children represents a sample from a sub-Saharan African context