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Stroke screening is lacking in children with sickle cell anemia

Many children with sickle cell anemia do not receive recommended screening for stroke, according to the Centers for Disease Control and Prevention (CDC).

Although stroke is a common complication of sickle cell disease, a CDC Vital signs report found that less than half of pediatric patients aged 2 to 16 with the disease are screened for stroke. This led to children not receiving valuable drugs such as hydroxyurea to reduce pain and acute chest syndrome.

Sickle cell disease is the most serious sickle cell disease, mainly affecting black people. An estimated 100,000 Americans are affected by sickle cell disease, and childhood strokes are most commonly caused by the disease.

Screening and use of hydroxyurea was most commonly seen in children with high healthcare utilization and those with prior complications. Forty-seven percent of children ages 2-9 and 38% of children ages 10-16 receive an ultrasound for stroke risk. Hydroxyurea is used by 2 out of 5 children aged 2 to 9 with sickle cell disease, and half of children aged 10 to 16.

“We must take steps to ensure that children with sickle cell anemia receive potentially life-saving treatment,” said Debra Houry, MD, MPH, CDC’s acting senior deputy director. “The pain and complications these children often experience can be excruciating and debilitating and can last for hours, days or even weeks. Preventative care and medications, such as hydroxyurea, can help relieve the pain and suffering these children endure and can prolong their lives.

According to Karen Remley, MD, MPH, director of the CDC’s National Center on Birth Defects and Developmental Disabilities, sickle cell anemia can shorten an individual’s life expectancy by more than 20 years. However, many people face barriers to testing and treatment, such as structural racism and concerns from parents and providers.

To help children with sickle cell disease receive the care they need, healthcare providers can perform screening in a single healthcare visit, while institutions adopt reporting systems to track and respond to behaviors. racists. Healthcare providers can also work with policy makers to reverse the impact of structural racism on sickle cell anemia funding, research and policy.

Parents can talk to health care providers to arrange a screening and determine next steps. To connect these parents to the resources they need, community organizations can develop resources for sickle cell patients and healthcare providers.

Reference

Many children with sickle cell disease do not receive life-saving screening and treatment. Centers for Control and Prevention of Disasters. September 20, 2022. Accessed October 24, 2022. https://www.cdc.gov/media/releases/2022/s0920-vs-sickle-cell-anemia.html

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