title: Stroke recurrence in Nigerian children with sickle cell disease treated with hydroxyurea.
abstract: OBJECTIVE
  To compare the outcome after a first clinical stroke, following treatment with and without hydroxyurea (HU).
  
  
  METHODS
  A retrospective review of a cohort of Nigerian children with SCD, who had suffered a first stroke, was carried out. Outcomes in the group of children who received and did not receive HU were compared.
  
  
  RESULTS
  Thirty two children presented with stroke and one died of haemorrhagic stroke at presentation. All the children had haemoglobin SS phenotype, and ischaemic stroke was the predominant form seen. Mean age at first clinical stroke was 7 years, 7 months (SD=2 years, 4 months). Thirteen children received HU while 18 declined HU therapy. Maximum dose of HU ranged from 20-25 mg/kg/ day. The secondary stroke incidence of 7/100 person years in the HU group was significantly lower than the 28/100 person years in the non-HU group (P=0.001, OR 3.808, 95% CI 1.556, 9.317). Children who did not receive HU were more likely to drop out of school and to have moderate-severe motor disabilities requiring caregiver assistance for daily living.
  
  
  CONCLUSIONS
  In settings where facilities for chronic blood transfusion are not accessible or feasible, HU therapy should be considered for secondary stroke prevention in children with SCD.
authors.affiliation: Department of Paediatrics College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: I A
authors.initials: IA
authors.lastname: Lagunju
authors.forename: B J
authors.initials: BJ
authors.lastname: Brown
authors.forename: O O
authors.initials: OO
authors.lastname: Sodeinde
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications* / Q000453:epidemiology*; D000986:Antisickling Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D008297:Male; D009048:Motor Skills; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D055502:Secondary Prevention; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000986:Antisickling Agents; D006918:Hydroxyurea