AUTHOR=Latham Teresa Smith , Czabanowska Katarzyna , Babich Suzanne , Yego-Kosgei Faith , Shook Lisa M. , Ware Russell E. 

TITLE=Primary Stroke Screening and Hydroxyurea Treatment for Sickle Cell Anemia in Pediatric Healthcare Settings in East and Central Africa: A Narrative Review of Capacity Gaps and Opportunities

JOURNAL=Public Health Reviews

VOLUME=Volume 46 - 2025

YEAR=2025

URL=https://www.ssph-journal.org/journals/public-health-reviews/articles/10.3389/phrs.2025.1608359

DOI=10.3389/phrs.2025.1608359

ISSN=2107-6952

ABSTRACT=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.