Clinical profile and middle cerebral artery velocity of children with sickle cell anaemia seen in UUTH, Uyo, Akwa Ibom state, Nigeria.

Abstract

Background: The risk of stroke in individuals with Sickle Cell Anaemia (SCA) can be assessed by routine non-invasive measurement of their cerebral blood flow using a Transcranial Doppler (TCD) ultrasound scan. This study
aimed to determine the difference in blood flow velocity parameters in the middle cerebral artery (MCA) of
children with sickle cell anaemia compared to a normal age-matched population.
Methodology: This was a hospital-based comparative cross-sectional study among 40 SCA patients aged 3-16
years, in steady state and 40 age and sex-matched HbAA healthy subjects. This study lasted from June to October
2019. Medical history was retrieved using a structured questionnaire. The time-averaged mean of maximum
velocity (TAMMV) of the right and left MCA was measured using non-imaging TCD.
Results: The mean age ± SD of the SCA patients was 9.1 ± 4.4 years. The SCA patients and sex and age-matched
HbAA group consisted of 23 (57.5%) males and 17 (42.5%) females respectively. SCA patients had a significantly
lower mean ± SD haemoglobin (Hb) than the controls (7.1 ± 1.1g/dl vs 11.1 ± 1.4g/dl; p<0.001). The right MCA of
the patients with SCA had a significantly higher mean flow velocity compared to the controls (94.1 ± 23.1 vs 55.0
± 8.8cm/sec, p<0.001).
Conclusion: The mean TAMMV recorded in the SCA subjects were significantly higher than that of the non-SCA
subjects. There is a need to ensure that TCD ultrasound is employed as a routine screening tool for stroke risk
among SCA patients in Nigerian tertiary health institutions.