4052.0: Tuesday, October 23, 2001 - Board 4

Abstract #29734

Stroke prevention in children with sickle cell disease: Sharing our knowledge in Ghana

Mira L. Katz, PhD1, Janet L. Kwiatkowski, MD2, Kwaku Ohene-Fempong, MD2, Osei Y. Akoto, MD3, and Daniel Ansong, MD3. (1) Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 1700 Airport Road, CB#3417, Chapel Hill, NC 27599, (919) 966-0355, mira_katz@med.unc.edu, (2) The Children's Hospital of Philadelphia, (3) Komfo Anokye Teaching Hospital

Stroke in African children with homozygous sickle cell disease (SCD) is thought to be less common than in the United States (U.S.). A reported prevalence of 2-5% versus 11% in the U.S. may reflect genetic and/or environmental variation of the disease, poor access to health care (including neuroradiological imaging studies), or inadequate patient and caregiver education. Transcranial Doppler ultrasound predicts the risk of stroke in children with SCD. Ultrasound tests were performed on 136 children (mean age of 7.5 years) attending the SCD clinic at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Medical charts were reviewed and families questioned for prior history or signs/symptoms of stroke. Eighteen children (13.2%) had elevated blood flow velocities suggesting an increased risk. After talking with the caregivers, two children with abnormal ultrasound tests also had histories suggestive of an undiagnosed stroke. A verbal educational session reviewing the warning signs and symptoms of stroke and instructions to immediately bring the child to the hospital if these symptoms occur was provided to the caregivers of the children identified at high risk. The major challenge faced was the language barrier when explaining the test and providing information about stroke warning signs/symptoms. This initial assessment of stroke risk in African children with SCD suggests that: 1) stroke is a problem that exists, 2) caregivers seemed uninformed that stroke was a potential complication and lacked knowledge about warning signs and symptoms, and 3) language-specific, culturally sensitive educational materials/programs focusing on stroke are needed for this population.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1) Discuss the potential benefits of providing stroke education to children with sickle cell disease and their caregivers, and 2) Describe the unique challenges faced when providing stroke education in Ghana.

Keywords: Child Health Promotion, Strokes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA