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Galadanci NA, Kanter J. Long-term data from the REACH study testing hydroxyurea to treat sickle cell anaemia in children in sub-Saharan Africa. Lancet Haematol 2024:S2352-3026(24)00096-6. [PMID: 38701813 DOI: 10.1016/s2352-3026(24)00096-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Najibah A Galadanci
- Division of Hematology and Oncology, UAB School of Medicine, University of Alabama, Birmingham, AL 35233, USA
| | - Julie Kanter
- Division of Hematology and Oncology, UAB School of Medicine, University of Alabama, Birmingham, AL 35233, USA.
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2
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Abdullahi SU, Sunusi S, Aminu H, Umar R, Abba MS, Jibir BW, Sani S, Gambo S, Bello-Manga H, Galadanci NA, Covert Greene B, Kassim AA, Jordan LC, Aliyu MH, Rodeghier M, DeBaun MR, Volanakis EJ. Transcranial doppler velocity in iron-deficient Nigerian children with sickle cell anemia. Am J Hematol 2024; 99:797-799. [PMID: 38323371 DOI: 10.1002/ajh.27230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/26/2023] [Accepted: 12/30/2023] [Indexed: 02/08/2024]
Abstract
Oral iron supplementation in iron deficient children with sickle cell anemia and normal transcranial Doppler ultrasound (TCD) velocities does not reduce arterial flow in the middle cerebral artery.
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Affiliation(s)
- Shehu Umar Abdullahi
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Surayya Sunusi
- Department of Pediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Hauwa Aminu
- Department of Pediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Rashida Umar
- Department of Pediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | | | - Saifuddeen Sani
- Department of Pediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Safiya Gambo
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Halima Bello-Manga
- Department of Hematology and Blood Transfusion, Barau-Dikko Teaching Hospital, Kaduna, Nigeria
| | - Najibah A Galadanci
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Brittany Covert Greene
- Department of Pediatrics, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adetola A Kassim
- Department of Hematology and Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Lori C Jordan
- Department of Pediatrics, Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Muktar H Aliyu
- Vanderbilt Institute for Global Health, Nashville, Tennessee, USA
| | | | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Emmanuel J Volanakis
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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3
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Galadanci AA, Estepp JH, Khan H, Farouk ZL, Caroll Y, Hodges J, Yarima S, Ibrahim UA, Idris IM, Gambo A, Hussaini N, Mukaddas A, DeBaun MR, Galadanci NA. Barriers and Facilitators of Premarital Genetic Counseling for Sickle Cell Disease in Northern Nigeria. J Pediatr Hematol Oncol 2023; 45:e716-e722. [PMID: 37494609 DOI: 10.1097/mph.0000000000002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/24/2023] [Indexed: 07/28/2023]
Abstract
In high-income countries, premarital genetic counseling for Sickle Cell Disease (SCD) is a standard practice. However, in Nigeria, there is no formal premarital genetic counseling program available for SCD. We conducted a series of focus group discussions with health care professionals, patients with SCD, and parents of the patients with or without SCD to gain an understanding of their attitudes and beliefs towards SCD/Sickle Cell Trait and premarital genetic counseling for SCD. Data were analyzed using Charmaz's constructivist grounded theory approach. Two themes were highlighted in the analysis as follows: (1) the difference between the perception of premarital sickle cell screening among individuals with SCD versus the general population, and (2) the personal beliefs and physical challenges that could lead to the avoidance of premarital screening within the general community. Lack of disease-related knowledge, testing facilities, transportation, and stigma associated with the disease were the most commonly perceived barriers to premarital testing. Also, a willingness to receive premarital testing for SCD exists within our community to reduce the spread of the disease and advocate for improved health-related quality of life of patients with SCD. The content and structure of a premarital genetic counseling program in Kano, Northern Nigeria, needs to be developed.
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Affiliation(s)
| | | | - Hamda Khan
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | - Zubaida L Farouk
- Centre for Infectious Diseases Research, Bayero University, Kano
| | - Yvonne Caroll
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | - Jason Hodges
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | | | | | | | - Awwal Gambo
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano Nigeria
| | - Nafiu Hussaini
- Department of Mathematical Sciences, Bayero University Kano
| | | | - Michael R DeBaun
- Department of Pediatrics, Division of Hematology and Oncology, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN
| | - Najibah A Galadanci
- Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL
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Galadanci NA, Johnson W, Carson A, Hellemann G, Howard V, Kanter J. Factors associated with left ventricular hypertrophy in children with sickle cell disease; results from the DISPLACE study. Haematologica 2022; 107:2466-2473. [PMID: 35417940 PMCID: PMC9521227 DOI: 10.3324/haematol.2021.280480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Cardiopulmonary complications remain a leading cause of morbidity and mortality in sickle cell disease (SCD). The overall goals of this study were to evaluate the relationship between left ventricular hypertrophy (LVH) and laboratory markers of hemolysis and determine the association between LVH and SCD-specific therapies (hydroxyurea and chronic red cell transfusion). Data from the DISPLACE (Dissemination and Implementation of Stroke Prevention Looking at the Care Environment) study cohort was used. LVH was defined based on the left ventricular mass indexed to the body surface area as left ventricular mass index >103.0 g/m2 for males and >84.2 g/m2 for females. There were 1,409 children included in the analysis and 20.3% had LVH. Results of multivariable analysis of LVH showed baseline hemoglobin levels were associated with the lower odds of having LVH (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.60– 0.84). The odds of LVH increases for every 1-year increase in age (OR: 1.07, 95% CI: 1.02-1.13). Similarly, the odds of LVH were lower among males than females (OR: 0.59, 95% CI: 0.38-0.93). The odds of LVH were higher among those on hydroxyurea compared to no therapy (OR: 1.83, 95% CI: 1.41–2.37). Overall results of the study showed that LVH occurs early in children with SCD and the risk increases with increasing age and with lower hemoglobin. Further, we found higher use of hydroxyurea among those with LVH, suggesting that the need for hydroxyurea conveys a risk of cardiovascular remodeling.
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Affiliation(s)
- Najibah A Galadanci
- Division of Hematology and Oncology, UAB School of Medicine, University of Alabama at Birmingham, Birmingham
| | - Walter Johnson
- Department of Pediatrics, UAB School of Medicine, University of Alabama at Birmingham, Birmingham
| | - April Carson
- Jackson Heart Study, University of Mississippi Medical Center, Jackson
| | - Gerhard Hellemann
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham
| | - Virginia Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham
| | - Julie Kanter
- Division of Hematology and Oncology, UAB School of Medicine, University of Alabama at Birmingham, Birmingham.
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Galadanci NA, Johnson W, Carson A, Hellemann G, Howard V, Kanter J. Association Between Patent Foramen Ovale and Overt Ischemic Stroke in Children With Sickle Cell Disease. Front Neurol 2021; 12:761443. [PMID: 34966346 PMCID: PMC8710657 DOI: 10.3389/fneur.2021.761443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Ischemic stroke is one of the most devastating complications of sickle cell anemia (SCA). Previous studies have shown that intracardiac shunting including patent foramen ovale (PFO) can be a potential risk factor for stroke in children with SCA. This study investigates the association between PFO and overt ischemic stroke in the DISPLACE (Dissemination and Implementation of Stroke Prevention Looking at the Care Environment) study cohort of 5,247 children with SCA of whom 1,414 had at least one clinical non-contrast transthoracic echocardiogram. Presence of PFO was taken from the clinical report. Further, we assessed the association between PFO and other clinical and hemolytic factors in children with SCA such as history of abnormal sickle stroke screen [elevated Transcranial Doppler ultrasound (TCD) velocity] and patient's baseline hemoglobin. In 642 children for whom all data were available, the adjusted odds ratio (OR) for overt stroke was higher in those with PFO but this was not statistically significant (OR: 1.49, 95% CI: 0.20-11.03, p = 0.6994). With an OR of 0.85, the study suggested less PFOs in those with abnormal TCD, but this was not statistically significant (95% CI: 0.17-4.25, p = 0.8463). Overall, the prevalence of PFO in this large sub study of non-contrast echocardiography amongst children with SCA is much lower than previous smaller studies using bubble contrast echocardiography. Overt stroke was non-statistically more common in children with SCA and PFO, but there was no evidence that PFO was more common in those with abnormal TCD, the most important pediatric sickle stroke screen.
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Affiliation(s)
- Najibah A Galadanci
- Division of Hematology and Oncology, UAB School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Walter Johnson
- Department of Pediatrics, UAB School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - April Carson
- Jackson Heart Study, University of Mississipi Medical Center, Jackson, MS, United States
| | - Gerhard Hellemann
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Virginia Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Julie Kanter
- Division of Hematology and Oncology, UAB School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Idris IM, Yusuf AA, Gwarzo DH, Kurawa MS, Shuaib A, Galadanci AA, Ibrahim H, Borodo AM, Jobbi YD, Danagundi MB, Borodo SB, Mohammed IY, Galadanci NA, Kuliya-Gwarzo A. High Systolic Blood Pressure, Anterior Segment Changes and Visual Impairment Independently Predict Sickle Cell Retinopathy. Hemoglobin 2021; 45:228-233. [PMID: 34353203 DOI: 10.1080/03630269.2021.1957927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sickle cell disease is often complicated by retinopathy, which can be proliferative or non proliferative. Proliferative sickle cell retinopathy potentially leads to blindness. There is a paucity of data on sickle cell disease-related retinopathy from Africa, where the disease is most prevalent. We aimed to determine the clinical, ophthalmic, and laboratory predictors of sickle cell retinopathy in an African population. We conducted a cross-sectional study of 262 participants, aged 13 years and above, with sickle cell disease. Demographic and clinical data were collected using a structured questionnaire and standard physical examinations. Vitreo-retinal specialists performed eye examinations on all the participants. Hematological and biochemical assessments were conducted using standard methods. A multivariate stepwise forward logistic regression was performed to determine the predictors of retinopathy. The median age of the participants was 20 years (interquartile range: 17-25 years). Most of the participants had a homozygous Hb S (HBB: c.20A>T) genotype (96.9%), with 3.1% who carried a Hb S/Hb C (HBB: c.19G>A) genotype. The prevalence of non proliferative sickle cell retinopathy was 24.4%. Only 1.9% had proliferative sickle cell retinopathy (PSCR). Elevated systolic blood pressure (BP) [odds ratio (OR): 6.85, 95% confidence interval (95% CI): 1.05-44.45, p = 0.059], moderate visual impairment (OR: 5.2, 95% CI: 1.39-19.63, p = 0.015), and anterior segment changes (OR: 2.21, 95% CI: 1.19-4.13, p = 0.012) were independently predictive of retinopathy. This study provides new insight into predictors of retinopathy in sickle cell disease, with implications on early screening and prevention.
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Affiliation(s)
- Ibrahim M Idris
- Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Aminu A Yusuf
- Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria.,College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - Dalha H Gwarzo
- Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria.,College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - Musbahu S Kurawa
- College of Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Abdulsalam Shuaib
- College of Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Aisha A Galadanci
- Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria.,College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - Hauwa Ibrahim
- Department of Hematology, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Awwal M Borodo
- Department of Hematology, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Yusuf D Jobbi
- Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Maryam B Danagundi
- Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Sakinatu B Borodo
- Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Idris Y Mohammed
- College of Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Chemical Pathology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Najibah A Galadanci
- Department of Epidemiology, University of Alabama at Birmingham, School of Public Health, Birmingham, AL, USA
| | - Aisha Kuliya-Gwarzo
- Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria.,College of Health Sciences, Bayero University Kano, Kano, Nigeria
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Abdullahi SU, Wudil BJ, Bello-Manga H, Musa AB, Gambo S, Galadanci NA, Aminu H, Gaya AT, Sanusi S, Tabari MA, Galadanci A, Borodo A, Abba MS, Dambatta AH, Haliru L, Gambo A, Cassell H, Rodeghier M, Ghafuri DL, Greene BVC, Neville K, Kassim AA, Kirkham F, Trevathan E, Jordan LC, Aliyu MH, DeBaun MR. Primary prevention of stroke in children with sickle cell anemia in sub-Saharan Africa: rationale and design of phase III randomized clinical trial. Pediatr Hematol Oncol 2021; 38:49-64. [PMID: 33236662 PMCID: PMC7954909 DOI: 10.1080/08880018.2020.1810183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Strokes in children with sickle cell anemia (SCA) are associated with significant morbidity and premature death. Primary stroke prevention in children with SCA involves screening for abnormal transcranial Doppler (TCD) velocity coupled with regular blood transfusion therapy for children with abnormal velocities, for at least one year. However, in Africa, where the majority of children with SCA live, regular blood transfusions are not feasible due to inadequate supply of safe blood, cost, and the reluctance of caregivers to accept transfusion therapy for their children. We describe the Primary Prevention of Stroke in Children with Sickle Cell Disease in Nigeria Trial [StrokePreventioninNigeria (SPRING) trial, NCT02560935], a three-center double-blinded randomized controlled Phase III clinical trial to 1) determine the efficacy of moderate fixed-dose (20 mg/kg/day) versus low fixed-dose (10 mg/kg/day) hydroxyurea therapy for primary stroke prevention; 2) determine the efficacy of moderate fixed-dose hydroxyurea for decreasing the incidence of all cause-hospitalization (pain, acute chest syndrome, infection, other) compared to low fixed-dose hydroxyurea. We will test the primary hypothesis that there will be a 66% relative risk reduction of strokes in children with SCA and abnormal TCD measurements, randomly allocated, for a minimum of three years to receive moderate fixed-dose versus low fixed-dose hydroxyurea (total n = 220). The results of this trial will advance the care of children with SCA in sub-Saharan Africa, while improving research capacity for future studies to prevent strokes in children with SCA.
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Affiliation(s)
- Shehu U. Abdullahi
- Department of Pediatrics, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Binta J. Wudil
- Department of Pediatrics, Hasiya Bayero Specialist Hospital, Kano Nigeria
| | - Halima Bello-Manga
- Department of Hematology and Blood Transfusion, Barau-Dikko Teaching Hospital, Kaduna Nigeria
| | - Aisha B. Musa
- Department of Pediatrics, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Safiya Gambo
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Najibah A. Galadanci
- Department of Epidemiology, School of Public health, University of Alabama at Birmingham, Alabama, USA
| | - Hauwa Aminu
- Department of Pediatrics, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Aliyu Tijjani Gaya
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Surayya Sanusi
- Department of Community Medicine, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Musa A. Tabari
- Department of Community Medicine, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Aisha Galadanci
- Department of Hematology and Blood Transfusion, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Awwal Borodo
- Department of Medicine, Murtala Mohammed Specialist Hospital
| | - Muhammed S. Abba
- Department of Pharmacy, Bayero University, Aminu Kano Teaching Hospital
| | - Abdu H. Dambatta
- Department of Community Medicine, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Lawal Haliru
- Department of Pediatrics, Kaduna State University, Barau Dikko Teaching Hospital
| | - Awwal Gambo
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Holly Cassell
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Djamila L. Ghafuri
- Department of Pediatrics, Division of Hematology and Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brittany V. Covert Greene
- Department of Pediatrics, Division of Hematology and Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kathleen Neville
- Department of Pediatrics, University of Kansas for Medical Sciences, Little Rock, AR, USA
| | - Adetola A. Kassim
- Department of Pediatrics, Division of Hematology and Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA;,Department of Hematology and Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Fenella Kirkham
- Department of Pediatrics, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Edwin Trevathan
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lori C. Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Muktar H. Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael R. DeBaun
- Department of Pediatrics, Division of Hematology and Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA;,Correspondence: Michael R. DeBaun, MD, MPH, Department of Pediatrics, Division of Hematology/ Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, 2525 West End Avenue, Suite 750, Nashville, TN 37203-1738, USA, Phone: (615) 875-3040 Fax: (615) 875-3055,
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Galadanci NA, Abdullahi SU, Ali Abubakar S, Wudil Jibir B, Aminu H, Tijjani A, Abba MS, Tabari MA, Galadanci A, Borodo AM, Belonwu R, Salihu AS, Rodeghier M, Ghafuri DL, Covert C Greene BV, Neville K, Kassim AA, Kirkham FJ, Jordan LC, Aliyu MH, DeBaun MR. Moderate fixed-dose hydroxyurea for primary prevention of strokes in Nigerian children with sickle cell disease: Final results of the SPIN trial. Am J Hematol 2020; 95:E247-E250. [PMID: 32510680 DOI: 10.1002/ajh.25900] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 05/31/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Najibah A. Galadanci
- Department of Epidemiology, School of Public Health University of Alabama at Birmingham Birmingham Alabama
| | - Shehu U. Abdullahi
- Department of Pediatrics Bayero University/Aminu Kano Teaching Hospital Kano Nigeria
| | - Shehi Ali Abubakar
- Department of Radiology Bayero University/Aminu Kano Teaching Hospital Kano Nigeria
| | - Binta Wudil Jibir
- Department of Pediatrics Hasiya Bayero Childrenʼs Hospital Kano Nigeria
| | - Hauwa Aminu
- Murtala Mohammed Specialist Hospital Kano Nigeria
| | | | - Muhammad S. Abba
- Department of Pharmacy Aminu Kano Teaching Hospital Kano Nigeria
| | - Musa A. Tabari
- Department of Radiology Barau‐Dikko Teaching Hospital Kaduna Nigeria
| | - Aisha Galadanci
- Department of Hematology Bayero University/Aminu Kano Teaching Hospital Kano Nigeria
| | - Awwal Musa Borodo
- Department of Medicine Murtala Muhammad Specialist Hospital Kano Nigeria
| | - Raymond Belonwu
- Department of Pediatrics Bayero University/Aminu Kano Teaching Hospital Kano Nigeria
| | - Auwal S. Salihu
- Department of Psychiatry Bayero University/Aminu Kano Teaching Hospital Kano Nigeria
| | | | - Djamila L. Ghafuri
- Division of Hematology and Oncology, Department of Pediatrics Vanderbilt‐Meharry of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee
| | - Brittany V. Covert C Greene
- Division of Hematology and Oncology, Department of Pediatrics Vanderbilt‐Meharry of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee
| | - Kathleen Neville
- Department of Pediatrics, Divisions of Pediatric Hematology‐Oncology and Clinical Pharmacology and Toxicology University of Arkansas for Medical Sciences Little Rock Arkansas
| | - Adetola A. Kassim
- Division of Hematology and Oncology Department of Medicine Vanderbilt University School of Medicine Nashville Tennessee
| | - Fenella J. Kirkham
- Department of Pediatrics University College of London, Great Ormond Street Institute of Child Health London UK
| | - Lori C. Jordan
- Division of Pediatric Neurology, Department of Pediatrics Vanderbilt University Medical Center Nashville Tennessee
| | | | - Michael R. DeBaun
- Division of Hematology and Oncology, Department of Pediatrics Vanderbilt‐Meharry of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee
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9
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Bello-Manga H, Galadanci AA, Abdullahi S, Ali S, Jibir B, Gambo S, Haliru L, Jordan LC, Aliyu MH, Rodeghier M, Kassim AA, DeBaun MR, Galadanci NA. Low educational level of head of household, as a proxy for poverty, is associated with severe anaemia among children with sickle cell disease living in a low-resource setting: evidence from the SPRING trial. Br J Haematol 2020; 190:939-944. [PMID: 32415792 DOI: 10.1111/bjh.16746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 02/06/2023]
Abstract
Severe anaemia, defined as haemoglobin level < 6·0 g/dl, is an independent risk factor for death in individuals with sickle cell disease living in resource-limited settings. We conducted a cross-sectional study of 941 children with sickle cell anaemia, who had been defined as phenotype HbSS or HbSβ0 thalassaemia, aged five to 12 years, and were screened for enrollment into a large primary stroke prevention trial in Nigeria (SPRING; NCT02560935). The main aim of the study was to determine the prevalence and risk factors for severe anaemia. We found severe anaemia to be present in 3·9% (37 of 941) of the SPRING study participants. Severe anaemia was significantly associated with the lower educational level of the head of the household (P = 0·003), as a proxy for poverty, and a greater number of children per room in the household (P = 0·004). Body mass index was not associated with severe anaemia. The etiology of severe anaemia in children living with sickle cell anaemia in Nigeria is likely to be multifactorial with an interplay between an individual's disease severity and other socio-economic factors related to poverty.
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Affiliation(s)
- Halima Bello-Manga
- Department of Hematology and Blood Transfusion, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Aisha A Galadanci
- Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital/Bayero University, Kano, Nigeria
| | - Shehu Abdullahi
- Department of Pediatrics, Aminu Kano Teaching Hospital/Bayero University, Kano, Nigeria
| | - Shehi Ali
- Department of Radiology, Aminu Kano Teaching Hospital/Bayero University, Kano, Nigeria
| | - Binta Jibir
- Department of Pediatrics, Hasiya Bayero Children's Hospital, Kano, Nigeria
| | - Safiya Gambo
- Department of Pediatrics, Murtala Muhammad Specialist Hospital Kano, Kano, Nigeria
| | - Lawal Haliru
- Department of Pediatrics, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Lori C Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University of Medicine, Nashville, TN, USA
| | - Muktar H Aliyu
- Family Medicine/Preventive Medicine, Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Adetola A Kassim
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael R DeBaun
- Department of Pediatrics, Division of Hematology-Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Najibah A Galadanci
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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10
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Galadanci AA, Galadanci NA, Jibir BW, Abdullahi SU, Idris N, Gambo S, Ali Abubakar SA, Kabo NA, Bello‐Manga H, Haliru L, Bashir I, Aliyu MH, Galadanci JA, DeBaun MR. Approximately 40 000 children with sickle cell anemia require screening with TCD and treating with hydroxyurea for stroke prevention in three states in northern Nigeria. Am J Hematol 2019; 94:E305-E307. [PMID: 31423630 DOI: 10.1002/ajh.25616] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Aisha A. Galadanci
- Department of Hematology and Blood TransfusionAminu Kano Teaching Hospital Kano Nigeria
| | - Najibah A. Galadanci
- Department of EpidemiologyUniversity of Alabama at Birmingham, School of Public Health
| | - Binta W. Jibir
- Department of PediatricsMurtala Mohammed Specialist Hospital Kano Nigeria
| | - Shehu U. Abdullahi
- Department of PediatricsBayero University/Aminu Kano Teaching Hospital Kano Nigeria
| | - Nura Idris
- Department of RadiologyMurtala Mohammed Specialist Hospital Kano Nigeria
| | - Safiya Gambo
- Department of PediatricsMurtala Mohammed Specialist Hospital Kano Nigeria
| | | | | | - Halima Bello‐Manga
- Department of Hematology and Blood TransfusionBarau Dikko Teaching Hospital/Kaduna State University Kaduna Nigeria
| | - Lawal Haliru
- Department of PediatricsBarau Dikko Teaching Hospital/Kaduna State University Kaduna Nigeria
| | - Ibrahim Bashir
- Department of HematologyFederal medical Center Katsina Nigeria
| | - Muktar H. Aliyu
- Health Policy, Vanderbilt Institute for Global Health, Vanderbilt University Medical Center Nashville Tennessee
| | | | - Michael R. DeBaun
- Vanderbilt‐Meharry Sickle Cell Disease Center for Excellence, Department of PediatricsVanderbilt University of Medicine Nashville Tennessee
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11
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Prussien KV, Salihu A, Abdullahi SU, Galadanci NA, Bulama K, Belonwu RO, Kirkham FJ, Yarboi J, Bemis H, DeBaun MR, Compas BE. Associations of transcranial doppler velocity, age, and gender with cognitive function in children with sickle cell anemia in Nigeria. Child Neuropsychol 2019; 25:705-720. [PMID: 30269648 PMCID: PMC6545195 DOI: 10.1080/09297049.2018.1526272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 09/12/2018] [Indexed: 12/16/2022]
Abstract
Children with sickle cell anemia (SCA) have elevated cerebral blood velocity relative to healthy peers. The primary aim of this study was to evaluate the association between cerebral blood velocity, measured by transcranial Doppler (TCD) ultrasound, age, and gender with cognitive function in children with SCA in Nigeria. Eighty-three children (Mage = 9.10, SD = 1.90 years; 55% female) with SCA in Nigeria completed cognitive assessments and a TCD ultrasound. The association between TCD velocity and measures of perceptual reasoning (Raven's Progressive Matrices), working memory (WISC-IV Digit Span), and executive planning (Tower of London, TOL) were assessed. Results showed that elevated TCD velocity significantly predicted lower scores on TOL Time Violations and Total Problem-Solving Time when controlling for BMI, hemoglobin level, and parent education, suggesting that TCD velocity is related to the efficiency of executive function. Further, age was negatively related to children's performance on the Ravens Matrices and TOL Total Correct, and boys showed greater deficits on the TOL Total Correct relative to girls. Moderation analyses for gender showed that there was a conditional negative association between TCD velocity and Digit Span for boys, but not for girls. Findings suggest that children with SCA in Nigeria with elevated TCD velocity are at risk for deficits in efficiency of executive planning, and boys with elevated TCD velocity are particularly at increased risk for deficits in auditory working memory. Implications of this study are important for interventions to reduce cerebral blood velocity and the use of TCD in this population.
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Affiliation(s)
- Kemar V. Prussien
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
| | - Auwal Salihu
- Department of Psychiatry, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Shehu U. Abdullahi
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Najibah A. Galadanci
- Department of Hematology and Blood Transfusion, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Khadija Bulama
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Raymond O. Belonwu
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Fenella J. Kirkham
- Developmental Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Janet Yarboi
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
| | - Heather Bemis
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
| | - Michael R. DeBaun
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bruce E. Compas
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
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12
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Galadanci AA, DeBaun MR, Galadanci NA. Neurologic complications in children under five years with sickle cell disease. Neurosci Lett 2019; 706:201-206. [PMID: 31039424 DOI: 10.1016/j.neulet.2019.04.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 02/27/2019] [Accepted: 04/12/2019] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Sickle Cell Disease (SCD) is one of the most common genetic diseases in the world affecting every organ. The major challenge in the medical care of children with SCD is preventing end-organ dysfunction, particularly the brain. Major neurologic complications in children less than five years with SCD include, but are not limited to, Silent cerebral infarct, cerebral sinus thrombosis, epilepsy, reversible encephalopathy syndrome, and ischemic and hemorrhagic stroke. Recurrent headaches and migraine are not rare in children under five years with SCD. This review will focus on the neurologic complications and the description of the modifiable risk factors in children less than 5 years of age with emphasis on differences between high and low resource settings. AREAS COVERED Neurologic complications of children under 5 years of age and the modifiable risk factors. The PUBMED database was searched using medical subject headings (MeSH) and keywords for articles regarding neurologic complications in children under 5 years of age. CONCLUSION Neurologic complications in children under five years of age with SCD may be more frequent than currently reported, among which Silent cerebral infarct and cognitive impairment are the most common.
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Affiliation(s)
- Aisha A Galadanci
- Department of Hematology and Blood Transfusion, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Najibah A Galadanci
- Department of Epidemiology, UAB School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233, USA.
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13
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Musa BM, Odoh CN, Galadanci NA, Saidu H, Aliyu MH. Lower than expected elevated tricuspid regurgitant jet velocity in adults with sickle cell disease in Nigeria. Int Health 2018; 10:356-362. [PMID: 29438485 DOI: 10.1093/inthealth/ihx074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 12/13/2017] [Indexed: 11/15/2022] Open
Abstract
Background Cardiopulmonary disease is a major cause of morbidity and mortality in persons with sickle cell disease (SCD). Tricuspid regurgitant jet velocity (TRJV) and predicted forced expiratory volume in 1 s (FEV1%) predicted are independently associated with death in SCD. The goal of this study was to determine the prevalence of elevated TRJV and the association, if any, between TRJV and FEV1% predicted among persons with sickle cell anaemia (SCA) in Nigeria. Methods Using a cross-sectional design, we enrolled 100 adult Nigerians (≥15 y) with SCA. We screened participants using Doppler echocardiogram to determine their TRJV and assessed their lung function with spirometry. Results The prevalence of elevated TRJV was 6%, with 74% of participants having low FEV1% predicted (<70%). TRJV was negatively correlated with FEV1%, but this finding was not statistically significant (Spearman's ρ=-0.0263, p=0.8058). Conclusions We found a low prevalence of elevated TRJV and a trend in association between TRJV and FEV1% predicted in Nigerian adults with SCA. Our findings underscore the need to explore further the relationship between SCD and cardiopulmonary disease in adults.
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Affiliation(s)
- Baba Maiyaki Musa
- Department of Medicine, Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Chisom N Odoh
- Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA
| | - Najibah A Galadanci
- Department of Hematology, Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Hadiza Saidu
- Department of Medicine, Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Muktar H Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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14
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Galadanci NA, Umar Abdullahi S, Vance LD, Musa Tabari A, Ali S, Belonwu R, Salihu A, Amal Galadanci A, Wudil Jibir B, Bello-Manga H, Neville K, Kirkham FJ, Shyr Y, Phillips S, Covert BV, Kassim AA, Jordan LC, Aliyu MH, DeBaun MR. Feasibility trial for primary stroke prevention in children with sickle cell anemia in Nigeria (SPIN trial). Am J Hematol 2018; 93:E83. [PMID: 29411418 DOI: 10.1002/ajh.25012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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15
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Musa BM, Adamu AL, Galadanci NA, Zubayr B, Odoh CN, Aliyu MH. Trends in prevalence of multi drug resistant tuberculosis in sub-Saharan Africa: A systematic review and meta-analysis. PLoS One 2017; 12:e0185105. [PMID: 28945771 PMCID: PMC5612652 DOI: 10.1371/journal.pone.0185105] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022] Open
Abstract
Background Multidrug resistant tuberculosis (MDR-TB), is an emerging public health problem in sub-Saharan Africa (SSA). This study aims to determine the trends in prevalence of MDR-TB among new TB cases in sub-Saharan Africa over two decades. Methods We searched electronic data bases and accessed all prevalence studies of MDR-TB within SSA between 2007 and 2017. We determined pooled prevalence estimates using random effects models and determined trends using meta-regression. Results Results: We identified 915 studies satisfying inclusion criteria. Cumulatively, studies reported on MDR-TB culture of 34,652 persons. The pooled prevalence of MDR-TB in new cases was 2.1% (95% CI; 1.7–2.5%). There was a non-significant decline in prevalence by 0.12% per year. Conclusion We found a low prevalence estimate of MDR-TB, and a slight temporal decline over the study period. There is a need for continuous MDR-TB surveillance among patients with TB.
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Affiliation(s)
- Baba Maiyaki Musa
- Department of Medicine, Bayero University, Kano, Nigeria
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
- * E-mail:
| | - Aishatu L. Adamu
- Department of Community Medicine, Bayero University, Kano, Nigeria
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Najibah A. Galadanci
- Department of Hematology, Bayero University, Kano, Nigeria
- Department of Hematology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Bashir Zubayr
- IHVN Regional Office, Institute of Human Virology, Kano, Nigeria
| | - Chisom N. Odoh
- University of Louisville, Louisville, Kentucky, United States of America
| | - Muktar H. Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
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16
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Galadanci NA, Umar Abdullahi S, Vance LD, Musa Tabari A, Ali S, Belonwu R, Salihu A, Amal Galadanci A, Wudil Jibir B, Bello-Manga H, Neville K, Kirkham FJ, Shyr Y, Phillips S, Covert BV, Kassim AA, Jordan LC, Aliyu MH, DeBaun MR. Feasibility trial for primary stroke prevention in children with sickle cell anemia in Nigeria (SPIN trial). Am J Hematol 2017; 92:780-788. [PMID: 28439953 DOI: 10.1002/ajh.24770] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/18/2017] [Indexed: 01/07/2023]
Abstract
The vast majority of children with sickle cell anemia (SCA) live in Africa, where evidence-based guidelines for primary stroke prevention are lacking. In Kano, Nigeria, we conducted a feasibility trial to determine the acceptability of hydroxyurea therapy for primary stroke prevention in children with abnormal transcranial Doppler (TCD) measurements. Children with SCA and abnormal non-imaging TCD measurements (≥200 cm/s) received moderate fixed-dose hydroxyurea therapy (∼20 mg/kg/day). A comparison group of children with TCD measurements <200 cm/s was followed prospectively. Approximately 88% (330 of 375) of families agreed to be screened, while 87% (29 of 33) of those with abnormal TCD measurements, enrolled in the trial. No participant elected to withdraw from the trial. The average mean corpuscular volume increased from 85.7 fl at baseline to 95.5 fl at 24 months (not all of the children who crossed over had a 24 month visit), demonstrating adherence to hydroxyurea. The comparison group consisted of initially 210 children, of which four developed abnormal TCD measurements, and were started on hydroxyurea. None of the monthly research visits were missed (n = total 603 visits). Two and 10 deaths occurred in the treatment and comparison groups, with mortality rates of 2.69 and 1.81 per 100 patient-years, respectively (P = .67). Our results provide strong evidence, for high family recruitment, retention, and adherence rates, to undertake the first randomized controlled trial with hydroxyurea therapy for primary stroke prevention in children with SCA living in Africa.
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Affiliation(s)
- Najibah A. Galadanci
- Department of Hematology and Blood Transfusion; Bayero University/Aminu Kano Teaching Hospital; Kano Nigeria
| | - Shehu Umar Abdullahi
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital; Kano Nigeria
| | - Leah D. Vance
- Doris Duke Clinical Research Mentorship Program; Vanderbilt University School of Medicine, Vanderbilt University Medical Center; Nashville Tennessee
| | | | - Shehi Ali
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital; Kano Nigeria
| | - Raymond Belonwu
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital; Kano Nigeria
| | - Auwal Salihu
- Department of Psychiatry, Bayero University/Aminu Kano Teaching Hospital; Kano Nigeria
| | - Aisha Amal Galadanci
- Department of Hematology and Blood Transfusion; Bayero University/Aminu Kano Teaching Hospital; Kano Nigeria
| | - Binta Wudil Jibir
- Department of Pediatrics; Murtala Mohammed Specialist Hospital; Kano Nigeria
| | - Halima Bello-Manga
- Department of Hematology and Blood Transfusion; Barau Dikko Teaching Hospital/Kaduna State University; Kaduna Nigeria
| | - Kathleen Neville
- Department of Pediatrics; University of Arkansas for Medical Sciences/Arkansas Children's Hospital; Little Rock Arkansas
| | - Fenella J. Kirkham
- Department of Developmental Neurosciences, UCL Institute of Child Health; London UK
| | - Yu Shyr
- Department of Biostatistics; Vanderbilt University School of Medicine; Nashville Tennessee
| | - Sharon Phillips
- Department of Biostatistics; Vanderbilt University School of Medicine; Nashville Tennessee
| | - Brittany V. Covert
- Department of Pediatrics, Vanderbilt University School of Medicine, Vanderbilt University Medical Center; Nashville Tennessee
| | - Adetola A. Kassim
- Department of Hematology and Oncology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center; Nashville Tennessee
| | - Lori C. Jordan
- Department of Pediatrics, Vanderbilt University School of Medicine, Vanderbilt University Medical Center; Nashville Tennessee
| | - Muktar H. Aliyu
- Department of Health Policy, Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Vanderbilt University Medical Center; Nashville Tennessee
| | - Michael R. DeBaun
- Department of Pediatrics, Vanderbilt University School of Medicine, Vanderbilt University Medical Center; Nashville Tennessee
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17
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Musa BM, Galadanci NA, Rodeghier M, Debaun MR. Higher prevalence of wheezing and lower FEV1 and FVC percent predicted in adults with sickle cell anaemia: A cross-sectional study. Respirology 2016; 22:284-288. [PMID: 27653959 DOI: 10.1111/resp.12895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/16/2016] [Accepted: 07/10/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Respiratory symptoms including wheezing are common in adults with sickle cell anaemia (SCA), even in the absence of asthma. However, the prevalence of spirometry changes and respiratory symptoms in adults with SCA is unknown. METHODS Using a cross-sectional study design, we tested the hypothesis that adults with SCA (cases) would have higher rates of lower airway obstruction and wheezing than those without SCA (controls) using the American Thoracic Society Division of Lung Diseases' questionnaire. Patients were adults with SCA aged between 18 and 65 years. Controls were consecutive unselected individuals without SCA who presented to an outpatient general medicine clinic. RESULTS We enrolled 150 adults with SCA and 287 consecutive controls without SCA. The median age was 23.0 and 27.0 years for adults with and without SCA, respectively. Cases were more likely to report cough without a cold (35.0% vs 18.6%, P < 0.001), lower forced expiratory volume in 1 s (FEV1 ) % predicted (70.1% vs 82.1%, P = 0.001) and lower forced vital capacity (FVC) % predicted (67.4% vs 74.9%, P = 0.001) than controls. In the multivariable model, wheezing was significantly associated with SCA status (OR = 1.69, 95% CI = 1.08-2.65, P = 0.024). Similarly, FEV1 % predicted was significantly associated with SCA status and wheezing (P = 0.001 for both). CONCLUSION Adults with SCA experience a higher rate of wheezing and impaired respiratory functions compared with controls from the same region.
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Affiliation(s)
- Baba M Musa
- Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Najibah A Galadanci
- Department of Haematology and Blood Transfusion, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Michael R Debaun
- Department of Pediatrics and Vanderbilt and Meharry Sickle Cell Disease Center of Excellence, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Vanderbilt and Meharry Sickle Cell Disease Center of Excellence, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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18
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Musa BM, Galadanci NA, Coker M, Bussell S, Aliyu MH. The global burden of pulmonary hypertension in sickle cell disease: a systematic review and meta-analysis. Ann Hematol 2016; 95:1757-64. [PMID: 27181705 DOI: 10.1007/s00277-016-2693-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/09/2016] [Indexed: 01/18/2023]
Abstract
Elevated tricuspid regurgitant jet velocity (TRJV) is a surrogate measure of pulmonary hypertension (PH) in persons with sickle cell disease (SCD). We sought to estimate the burden of PH in people living with sickle cell disease based on TRJV. From 2000 to 2015, we searched electronic databases for eligible publications and included 29 studies (n = 5358 persons). We used random effects modeling to determine the pooled estimate of elevated TRJV. The overall pooled prevalence of elevated TRJV was 23.5 %(95 % CI 19.5-27.4) in persons with SCD. The pooled prevalence of elevated TRJV in children and adults with SCD was 20.7 % (95 % CI 15.7--25.6) and 24.4 % (95 % CI 18.4-30.4), respectively. TRJV is prevalent among adults and children with SCD. Our finding support international recommendations that call for screening for PH in SCD patients.
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Affiliation(s)
- B M Musa
- Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
| | - N A Galadanci
- Department of Hematology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - M Coker
- Institute of Human Virology, University of Maryland, Baltimore, USA
| | - S Bussell
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - M H Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.,Departments of Family and Community Medicine, Meharry Medical College, Nashville, USA
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19
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Galadanci NA, Abdullahi SU, Tabari MA, Abubakar S, Belonwu R, Salihu A, Neville K, Kirkham F, Inusa B, Shyr Y, Phillips S, Kassim AA, Jordan LC, Aliyu MH, Covert BV, DeBaun MR. Primary stroke prevention in Nigerian children with sickle cell disease (SPIN): challenges of conducting a feasibility trial. Pediatr Blood Cancer 2015; 62:395-401. [PMID: 25399822 PMCID: PMC4304992 DOI: 10.1002/pbc.25289] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 09/05/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND The majority of children with sickle cell disease (SCD), approximately 75%, are born in sub-Saharan Africa. For children with elevated transcranial Doppler (TCD) velocity, regular blood transfusion therapy for primary stroke prevention is standard care in high income countries, but is not feasible in sub-Saharan Africa. PROCEDURE In the first U.S. National Institute of Health (NIH) sponsored SCD clinical trial in sub-Saharan Africa, we describe the protocol and challenges unique to starting a clinical trial in this region. We are conducting a single arm pilot trial of hydroxyurea therapy in children with TCD velocity ≥200 cm/sec in the middle cerebral arteries. Eligible children will be placed on hydroxyurea (n = 40) and followed for 3 years at Aminu Kano Teaching Hospital, Nigeria. Adherence will be measured via the Morisky Scale and adverse events will be determined based on hospitalization. RESULTS Originally, a randomized placebo trial was planned; however, placebo was not approved by the local Ethics Committee. Hence a single arm trial of hydroxyurea will be conducted and five controls per patient with normal TCD measurements will be followed to compare the rate of adverse events to those with abnormal TCD measurements taking hydroxyurea. Using non-NIH funding, over 9 months, multiple face-to-face investigator meetings were conducted to facilitate training. CONCLUSION A hydroxyurea trial (NCT01801423) for children with SCD is feasible in sub-Saharan Africa; however, extensive training and resources are needed to build a global patient oriented multi-disciplinary research team with a common purpose.
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Affiliation(s)
- Najibah A. Galadanci
- Department of Haematology and Blood Transfusion, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Shehu U. Abdullahi
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Musa A. Tabari
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Shehi Abubakar
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Raymond Belonwu
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Auwal Salihu
- Department of Psychiatry, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Kathleen Neville
- Department of Pediatric Hematology/Oncology, University of Missouri-Kansas City School of Medicine, USA
| | - Fenella Kirkham
- Department of Pediatrics, University College of London Institute of Child Health, London, UK
| | - Baba Inusa
- Department of Pediatrics, Evelina's Children's Hospital, Guy's and St. Thomas’, London, UK
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University School of Medicine,Nashville, TN, USA
| | - Sharon Phillips
- Department of Biostatistics, Vanderbilt University School of Medicine,Nashville, TN, USA
| | - Adetola A. Kassim
- Department of Hematology and Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Lori C. Jordan
- Department of Pediatrics, Neurology, Vanderbilt University Medical Center, Nashville, TN USA
| | | | - Brittany V. Covert
- Department of Pediatrics, Hematology and Oncology, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael R. DeBaun
- Department of Pediatrics, Hematology and Oncology, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA,Correspondence and reprint requests to: Michael R. DeBaun, MD, MPH, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Department of Pediatrics, Vanderbilt University School of Medicine, 2200 Children's Way, Room 11206 DOT, Nashville, TN 37232-9000, USA, Phone: 615-875-3040, Fax: 615-875-3055,
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