Stroke prevalence amongst sickle cell disease patients in Nigeria: a multi-centre study

Madu, AJ; Aliyu, Galadanci Najiba; Nalado, Aisha M.; Garba, Kangiwa Umar; Florence, Fowodu O; Hassan, Ahmed; Inyama, Marcus; Akinpelu, Oluwaseun; Nwagha, Theresa Ukamaka; Godswill, Ibegbulam Obike; Ocheni, S; Ifeoma, Emodi; Ikefuna, AN; Batholomew, Chukwu; Chide, Okocha Emmanuel; Joseph, Orkuma; Malachy, Iheanacho; Korubo, Kaladada; Sabastine, Anike Uchenna; Akaba, Kingsley; Nonyelu, Charles; Ugwu, Angela Ogechukwu; Duru, Augustin; Anigbo, Chukwudi; Eze, Alozie; Chukwurah, Awele; Ololo, Uchenna; Omoti, Caroline Edijana; Agwu, Obineche; Iheanyi, Okpala

doi:10.4314/ahs.v14i2.22

Cited by 20 publications

(9 citation statements)

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“…Stroke and other neurological complications of SCD are significant but preventable causes of disability and reduced quality of life. We got a prevalence of 3.7% which is similar to that obtained in the same centre in an earlier study (3.37%) [37] but at variance, with a another study carried out in the same centre but on a younger patient population (2.25%) and a multicenter Nigerian study (1.24%) [37]. These differences may be attributed to differences in age as well as environmental and genetic composition present in the different regions respectively [37].…”

Section: Discussionsupporting

confidence: 86%

“…In our study population of adult SCD patients, we recorded a prevalence of 1.85% which is lower than reports from the South-West (3.3%) and northern Nigeria (25.0%) [38,39]. Again, the differences may be explained by selection bias [38] and contributions of socioeconomic, genetic and environmental factors to phenotypic expression of the disease [37,38].…”

Section: Discussioncontrasting

confidence: 57%

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Variations and characteristics of the various clinical phenotypes in a cohort of Nigerian sickle cell patients

et al. 2021

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Background: Sickle cell anaemia affects about 4 million people across the globe, making it an inherited disorder of public health importance. Red cell lysis consequent upon haemoglobin crystallization and repeated sickling leads to anaemia and a baseline strain on haemopoiesis. Vaso-occlusion and haemolysis underlies majority of the chronic complications of sickle cell. We evaluated the clinical and laboratory features observed across the various clinical phenotypes in adult sickle cell disease patients. Methods: Steady state data collected prospectively in a cohort of adult sickle cell disease patients as out-patients between July 2010 and July 2020. The information included epidemiological, clinical and laboratory data. Results: About 270 patients were captured in this study (165 males and 105 females). Their ages ranged from 16 to 55 years, with a median age of 25 years. Sixty-eight had leg ulcers, 43 of the males had priapism (erectile dysfunction in 8), 42 had AVN, 31 had nephropathy, 23 had osteomyelitis, 15 had osteoarthritis, 12 had cholelithiasis, 10 had stroke or other neurological impairment, 5 had pulmonary hypertension, while 23 had other complications. Frequency of crisis ranged from 0 to >10/year median of 2. Of the 219 recorded, 148 of the patients had been transfused in the past, while 71 had not. Conclusion:The prevalence of SLU, AVN, priapism, nephropathy and the other complications of SCD show some variations from other studies. This variation in the clinical parameters across different clinical phenotypes indicates an interplay between age, genetic and environmental factors.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 57%

Variations and characteristics of the various clinical phenotypes in a cohort of Nigerian sickle cell patients

et al. 2021

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“…The 5 studies reporting data on stroke recurrence are listed in table e-2. 22 , 24 , 26 – 28 The prevalence of recurrent stroke varied from 18.2% (2/11) to 77.8% (14/18). In one study, 28 the incidence of stroke recurrence was 28/100 person-years in 18 patients not taking hydroxyurea and 7/100 person-years in 13 patients on hydroxyurea.…”

Section: Resultsmentioning

confidence: 99%

Neurologic complications of sickle cell disease in Africa

et al. 2017

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Objective:To summarize prevalence data on the neurologic complications of sickle cell disease (SCD) in Africa.Methods:We searched EMBASE, PubMed, and African Index Medicus to identify all relevant articles published from inception to May 31, 2016. Each study was reviewed for methodologic quality. A random-effects model was used to estimate the prevalence of neurologic complications of SCD across studies.Results:Thirty-one studies were included. Methodologic quality was high or moderate in 90% of studies. Stroke, conditional and abnormal cerebral blood flow, seizures, and headache were the complications most frequently reported, with overall prevalence rates of 4.2%, 10.6%, 6.1%, 4.4%, and 18.9%, respectively. Some complications, like silent brain infarcts, peripheral neuropathies, neurocognitive deficits, or moyamoya disease, have been rarely or not studied at all in the African setting. Incidence data were scarce and of poor quality.Conclusions:The burden of neurologic complications of SCD is important in Africa and most likely underestimated. A better evaluation of this burden requires larger prospective studies using standard up-to-date screening methods. Accessibility to diagnostic tools such as neuroimaging, transcranial Doppler, EEG, and neuropsychological evaluation, as well as to preventive and therapeutic interventions and trained health care providers, should be improved in routine clinical practice.

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“…5 Between the ages of 20 and 30 years, ischemic CVA is replaced by hemorrhagic CVA. 5 The prevalence of stroke in patients with SCD in a multi-centre study in Nigeria was 12.4%, 6 thus affirming that the occurrence of stroke as a complication of SCD is common among Nigerian patients.…”

Section: Introductionmentioning

confidence: 92%

Relationships Between Transcranial Doppler Velocity, Von Willebrand Factor, Factor VIII, and Hematological Parameters in Children with Sickle Cell Anemia: A Comparative Cross-Sectional Study

Enifeni¹,

Ogbenna

Daramola³

et al. 2022

Clin Med�Insights�Blood�Disord

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Background and Objectives Sickle cell anemia (SCA) is associated with recurrent acute inflammatory processes. These inflammatory processes could lead to elevation of Factor VIII and Von Willebrand Factor levels, thereby increasing the risk of stroke in SCA children. This study aims to determine vWF/FVIII levels in children with SCA and their association with abnormal transcranial Doppler (TCD). Subjects and Methods This study enrolled 75 children, including 24 SCA cases with normal TCD, 27 SCA cases with abnormal TCD, and 24 Hb AA controls, all aged between 2 and 16 years. Transcranial Doppler (TCD) ultrasound was performed to measure the cerebral blood velocity. Venous blood drawn from each participant was used to determine the levels of von Willebrand Factor Antigen (vWF: Ag) and Factor VIII (FVIII) and the complete blood count (CBC). Relationships among the measured parameters were determined using SPSS version 25. Statistical significance was set at P < .05. Results FVIII and vWF levels were significantly higher among children with SCA compared to the Hb AA controls ( P < .001). Although SCA patients with abnormal TCD tended to have higher levels of FVIII and vWF, this result did not attain statistical significance ( P > .05). There was a moderate negative correlation between the left middle cerebral artery and FVIII, (r = −0.332; P = .017). Children with SCA showing an abnormal TCD velocity had significantly higher platelet count compared to those with normal TCD ( P = .018). Conclusion Children with SCA have elevated levels of FVIII and vWF, and an abnormal TCD velocity is associated with elevated platelet count.

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Stroke prevalence amongst sickle cell disease patients in Nigeria: a multi-centre study

Cited by 20 publications

References 6 publications

Variations and characteristics of the various clinical phenotypes in a cohort of Nigerian sickle cell patients

Variations and characteristics of the various clinical phenotypes in a cohort of Nigerian sickle cell patients

Neurologic complications of sickle cell disease in Africa

Relationships Between Transcranial Doppler Velocity, Von Willebrand Factor, Factor VIII, and Hematological Parameters in Children with Sickle Cell Anemia: A Comparative Cross-Sectional Study

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