title: Capacity building and stroke risk assessment in Nigerian children with sickle cell anaemia.
abstract: BACKGROUND
  Transcranial Doppler ultrasonography (TCD) measures blood flow velocities in the large cerebral vessels and thus, detects the risk of stroke. This report describes a capacity building program which enabled the use of TCD for detecting stroke risk and also describes the pattern of non-imaging TCD examinations seen in Nigerian children with sickle cell anaemia (SCA).
  
  
  METHODS
  Ten university graduates were trained on the use of TCD in a 5-day capacity building workshop after which, the three best candidates were employed to provide a 5-day a week TCD screening service in Lagos. Data from TCD examination collected between March 2011 and September 2013 were analysed and reported.
  
  
  RESULTS
  Between March 2011 and September 2013, 2,331 children with SCA aged 2-16 years had TCD studies. TCD's findings were classified as normal (standard risk) in 70.4%, conditional in 19% and abnormal (high risk) in 9.3%. The majority of children (76.9%) in the high risk category were aged 2-8 years. TCD study was inadequate for risk categorisation in 1.3% of the patients.
  
  
  CONCLUSIONS
  Effective capacity building of middle level manpower is feasible and can provide a credible TCD screening service to communities with a high demand and a shortage of trained professionals. The pattern of TCD abnormalities seen in Africa are comparable to those obtained in several previous worldwide reports.
authors.affiliation: Department of Radio-diagnosis, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Kofo
authors.initials: K
authors.lastname: Soyebi
authors.forename: Titilope
authors.initials: T
authors.lastname: Adeyemo
authors.forename: Oyesola
authors.initials: O
authors.lastname: Ojewunmi
authors.forename: Funmi
authors.initials: F
authors.lastname: James
authors.forename: Kunle
authors.initials: K
authors.lastname: Adefalujo
authors.forename: Olu
authors.initials: O
authors.lastname: Akinyanju
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000503:physiopathology; D001783:Blood Flow Velocity; D057191:Capacity Building; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009549:Nigeria; D011379:Prognosis; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
keywords: Nigeria; Transcranial Doppler ultrasonography; cerebral blood flow velocity; sickle cell anaemia; stroke prevention