Factors Associated with Elevated Transcranial Doppler Ultrasound Velocities in Children with Sickle Cell Anemia in Mwanza, Tanzania (Record no. 18521)

MARC details
000 -LEADER
fixed length control field 06459nam a22003497a 4500
001 - CONTROL NUMBER
control field CUHAS/MMED/6000207/T/16
003 - CONTROL NUMBER IDENTIFIER
control field CUHAS/MMED/6000207/T/16
005 - DATE AND TIME OF LATEST TRANSACTION
control field 20240422151433.0
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 210821b |||||||| |||| 00| 0 eng d
028 ## - PUBLISHER OR DISTRIBUTOR NUMBER
Source Wurzburg Road 35, BMC Premises, Post Code: 33102:
Source P. O Box 1464, Mwanza – Tanzania:
Source Phone: +255 28 298 3384:
Source Fax: +255 28 298 3386:
Source Email: vc@bugando.ac.tz :
Source Website: www.bugando.ac.tz
035 ## - SYSTEM CONTROL NUMBER
System control number CUHAS/MMED/6000207/T/16
040 ## - CATALOGING SOURCE
Language of cataloging English
Transcribing agency ddc
041 ## - LANGUAGE CODE
Language code of text/sound track or separate title English
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Georgina George Balyorugulu
Dates associated with a name [Female]
9 (RLIN) 22851
Relator term CUHAS/MMED/6000207/T/16
210 ## - ABBREVIATED TITLE
Abbreviated title ABBREVIATIONS
Qualifying information ACA Anterior Cerebral Artery BCL11A B-Cell Lymphoma/Leukemia 11A BMC Bugando Medical Centre BMI Body Mass Index CAR Central African Republic Ca++ Calcium ion Cl- Chloride ion dICA Distal Internal Carotid Artery ENPP1 Ectonucleotide Pyrophosphatase/Phosphodiesterase 1gene FBP Full Blood Picture G6PD Glucose 6 Phosphate Dehydrogenase GOLGB1 Golbin B1 Hb Hemoglobin HbF Fetal hemoglobin HbS Hemoglobin S HbSS Hemoglobin SS (Homozygous) HbSβ+ Hemoglobin S/ beta plus thalassemia HbSβ° Hemoglobin S/beta zero thalassemia HED Hemolysis-endothelial dysfunction sub phenotype K+ Potassium ion LDH Lactate Dehydrogenase MCA Middle Cerebral Arteryxi MCHC Mean Corpuscular Hemoglobin Concentration MCV Mean Corpuscular Volume MRA Magnetic Resonance Angiography MRI Magnetic Resonance Imaging mRNA messenger Ribonucleic acid NAD Nicotinamide Adenine Dinucleotide Rh Rhesus factor SCA Sickle Cell Anemia SCD Sickle Cell Disease SCI Silent cerebral infract SCR Sickle cell retinopathy SNP Single nucleotide polymorphism TAMMV Time Average Mean of Maximum Velocity TCD Transcranial Doppler Ultrasound vWF Von Willebrand factor
222 ## - KEY TITLE
Key title OPERATIONAL DEFINITIONS
Qualifying information 1. Transcranial Doppler (TCD) ultrasonography velocities findings were defined as adapted from Stroke prevention trial (STOP) in sickle cell disease, as follows;  Abnormal TCD velocity ultrasonography findings are defined as either Time Averaged Mean of Maximum Velocity (TAMMV) ≥ 200 cm/s in dICA (distal Internal Carotid Artery) and/ or MCA (Middle Cerebral Artery), Low velocity < 100cm/s or nonvisualization of MCA in a patient with adequate windows.  Conditional TCD velocity ultrasonography findings are defined TAMMV >170cm/s but < 200cm/s in the MCA or dICA.  In this study, both abnormal and conditional TAMMV were considered as elevated TCD (>170cm/s) findings.  Normal findings were defined as TCD ultrasonography with TAMMV ≤170cm/s.  Inadequate window is defined as failure to detect the velocity of one of the cerebral vessels; MCA, dICA, the bifurcation (BIF) and the bilateral M1 (the shallowest portion of MCA), by using the TCD non imaging technique through either the left or right transtemporal window.
Key title OPERATIONAL DEFINITIONS
Qualifying information 2. Sickle Cell Anemia (SCA) patient was defined as a patient with homozygous HbS (Hemoglobin S) resulting into HbSS. 3. Routine TCD is the screening of risk of stroke that is done for SCA children at first visit to the clinic and the following visits according to the results of the previous TCD velocity. For those with normal TCD screened is done annually, conditional TCD screening is repeated 3-6 months depending on the clinical status and abnormal TCD screening is repeated after 2 weeks and patient is the followed monthly.
245 ## - TITLE STATEMENT
Title Factors Associated with Elevated Transcranial Doppler Ultrasound Velocities in Children with Sickle Cell Anemia in Mwanza, Tanzania
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Place of publication, distribution, etc. Mwanza, Tanzania:
Name of publisher, distributor, etc. Catholic University of Health and Allied Sciences [CUHAS - Bugando] :
Date of publication, distribution, etc. 2020
300 ## - PHYSICAL DESCRIPTION
Extent xiv; 71 Pages
Extent Includes References and Appendices
520 ## - SUMMARY, ETC.
Summary, etc. Abstract:<br/><br/>Background: Sickle cell anemia (SCA) is associated with several major complications including cerebral vascular diseases such as stroke, with 11% being affected before the age of 20 years. In Northwestern Tanzania, the prevalence of stroke among children living with SCA under the age 15 years is 16.9%. Due to the absence of routine screening modalities by using Transcranial Doppler Ultrasound (TCD) and provision of preventive prophylaxis measures such as chronic blood transfusion, a higher risk of stroke might be prevalent in this population in our setting. TCD has led to the reduction of stroke prevalence by 92% following introduction of prophylactic blood transfusion for those with abnormal TCD. Despite the benefits of screening, TCD has low positive predictive value with 60% among those who screened positive for risk of stroke end up not developing stroke. Additional factors such hemoglobin level have been studied for identification of those at risk of stroke which can be used as adjuvant tools for clinical guidance in preventive measures of stroke.<br/><br/>Methods: This was a cross section study, which enrolled 267 SCA children aged 2 to 16 years attending Bugando Medical Centre Pediatric Sickle Cell Clinic from July 2019 to June 2020. Assessment of factors associated with elevated TCD included a clinical history of stroke in sibling, death history in sibling, oxygen saturation in room air, blood pressure (Systolic and Diastolic), hemoglobin level and total white blood cell count. TCD was done by accessing transtemporal window on both sides and recording the highest time average mean of maximum velocity (TAMMV) of major vessels mainly, middle cerebral artery (MCA) and distal internal carotid artery (dICA).<br/><br/>Results: The median age of enrolled was 6.6 (IQR: 4-9) years. The prevalence of elevated TCD (>170cm/s) was found to be 21% (56/267). By multivariate logistic regression, low oxygen saturation in room air, p-value = 0.037, OR 0.92 [95% CI 0.85-0.10] and low hemoglobin level, p-value=0.001, OR 0.57 [95% CI 0.41-0.79] were statistically significantly associated with elevated TCD among children living with SCA.<br/><br/>Conclusion: A proportion of children with elevated TCD were detected, which is associated with low hemoglobin and low oxygen saturation. These factors seen in this study warrants their incorporation in the screening of risk of stroke in children with SCA aged 2 to 16 years.<br/>
600 ## - SUBJECT ADDED ENTRY--PERSONAL NAME
General subdivision Pediatrics and Child Health
9 (RLIN) 48299
700 ## - ADDED ENTRY--PERSONAL NAME
9 (RLIN) 22852
9 (RLIN) 22737
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Source of classification or shelving scheme ddc
Koha item type POSTGRADUATE DISSERTATIONS
Holdings
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            MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO   08/21/2021   PD0382 08/21/2021 08/21/2021 POSTGRADUATE DISSERTATIONS
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