Use of Transcranial Doppler for the Monitoring of Major Sickle Cell Syndromes in Senegal: A Preliminary Analysis

Cerebral vasculopathy exposes patients with a high risk of stroke in people with major sickle cell syndromes (MDS). This can lead to death or significant disability. Transcranial Doppler (DTC) is a non-invasive medical imaging technique that measures the speed of blood flow in the vessels of the brain and detects the risk of this major complication of sickle cell anemia. The introduction of appropriate transfusion therapy reduces the risk of morbidity and mortality in children. Within the Outpatient Care Unit for Children and Adolescents with Sickle Cell (USAD), of the Albert Royer National Children's Hospital Center (CHNEAR), the realization of DTC was initiated in 2021. The objective of our study was to describe the results obtained during the follow-up of patients in whom DTC was performed. This was a retrospective, descriptive, and analytical study in patients followed for SDM at the USAD who underwent transcranial Doppler ultrasound from June 30, 2021 to June 30, 2022. During our study period, 4836 patients with SDM were seen in consultations, among them, 51 had benefited from DTC, i.e. a completion rate of 1.16%. The sex ratio was 1.78 and the average age was 7.2 years. Children aged 6-10 were in the majority (75.51%). Regarding DTC results, 4 (7.85%) were pathological, 8 (15.68%) were borderline, and 39 (76.47%) were normal. A statistically significant link was found between the history of hospitalization, the reticulocyte rate (>150000 elements/mm³) with the occurrence of abnormal circulatory velocities at DTP. Patients with pathological DTCs were put on a monthly transfusion subprogramme for 3 months. Hydroxyurea was offered as a relay to transfusions. Monitoring was quarterly for borderline results and annual for normal results. Transcranial Doppler ultrasound detects cerebral vasculopathy early in children with sickle cell disease, thus preventing stroke. This Senegalese study highlights the importance of systematic screening to improve therapeutic management. Keywords: Transcranial Doppler ultrasound, cerebral vasculopathy, sickle cell disease.