REVIEW
Public Health Rev
Volume 46 - 2025 | doi: 10.3389/phrs.2025.1608359
Primary Stroke Screening and Hydroxyurea Treatment for Sickle Cell Anemia in Pediatric Healthcare Settings within East and Central Africa: A Narrative Review of Capacity Gaps and Opportunities
Teresa Smith Latham1,2,3*
Katarzyna Czabanowska4,5
Suzanne Babich4,5
Faith Yego-Kosgei5,6Lisa M Shook1,2Russell E. Ware1,2,3- 1Cincinnati Children's Hospital Medical Center, Cincinnati, United States
- 2College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States
- 3Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- 4Maastricht University, Maastricht, Netherlands
- 5Richard M. Fairbanks School of Public Health, Indiana University, Purdue University Indianapolis, Indianapolis, Indiana, United States
- 6Moi University, Eldoret, Kenya
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Background/ObjectiveSickle cell anemia (SCA) is associated with increased morbidity and mortality and significantly impacts resource-limited settings where capacity for diagnosis and treatment are limited. This review provides context for the magnitude of the problem, describes screening methods to prevent stroke, and factors which impact outcomes.MethodsA narrative review was conducted. Themes included background information on SCA, its clinical characteristics, complications including primary stroke, and available treatment options. Social, economic, and political factors within East and Central Africa were described.Results37 publications were categorized into four themes: morbidity and mortality of SCA in sub-Saharan Africa; TCD screening for risk of primary stroke in children; treatment of children with SCA within resource-limited settings; and approaches to capacity gaps. ConclusionsSCA represents a public health problem in sub-Saharan Africa. TCD screening with hydroxyurea treatment can improve clinical outcomes and prevent primary stroke. Multiple barriers exist, including limited diagnostic screening, inconsistent availability of and access to hydroxyurea, and knowledge gaps. These barriers are influenced by social, economic and policy factors which can be addressed to build capacity and improve outcomes.
Keywords: sickle cell anemia, Stroke, Hydroxyurea, resource-limited settings, capacity building
Received: 20 Jan 2025; Accepted: 28 Apr 2025.
Copyright: © 2025 Latham, Czabanowska, Babich, Yego-Kosgei, Shook and Ware. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Teresa Smith Latham, Cincinnati Children's Hospital Medical Center, Cincinnati, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.