title: Risk factors for high cerebral blood flow velocity and death in Kenyan children with Sickle Cell Anaemia: role of haemoglobin oxygen saturation and febrile illness.
abstract: High cerebral blood flow velocity (CBFv) and low haemoglobin oxygen saturation (SpO(2)) predict neurological complications in sickle cell anaemia (SCA) but any association is unclear. In a cross-sectional study of 105 Kenyan children, mean CBFv was 120 +/- 34.9 cm/s; 3 had conditional CBFv (170-199 cm/s) but none had abnormal CBFv (>200 cm/s). After adjustment for age and haematocrit, CBFv > or =150 cm/s was predicted by SpO(2) < or = 95% and history of fever. Four years later, 10 children were lost to follow-up, none had suffered neurological events and 11/95 (12%) had died, predicted by history of fever but not low SpO(2). Natural history of SCA in Africa may be different from North America and Europe.
authors.affiliation: Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania. jmakani@muhas.ac.tz
authors.forename: Julie
authors.initials: J
authors.lastname: Makani
authors.forename: Fenella J
authors.initials: FJ
authors.lastname: Kirkham
authors.forename: Albert
authors.initials: A
authors.lastname: Komba
authors.forename: Tolulope
authors.initials: T
authors.lastname: Ajala-Agbo
authors.forename: Godfrey
authors.initials: G
authors.lastname: Otieno
authors.forename: Gregory
authors.initials: G
authors.lastname: Fegan
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Williams
authors.forename: Kevin
authors.initials: K
authors.lastname: Marsh
authors.forename: Charles R
authors.initials: CR
authors.lastname: Newton