{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:44:45Z","timestamp":1789706685609,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The greatest burden of sickle cell disease (SCD) globally occurs in sub\u2010Saharan Africa, where significant morbidity occurs secondary to SCD\u2010induced vasculopathy and stroke. Transcranial doppler (TCD) ultrasound grades the severity of vasculopathy, with disease modifying therapy resulting in stroke risk reduction in high\u2010risk children. The feasibility and utility of TCD screening in young children with SCD remains understudied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We performed a retrospective review of TCD examination results in children \u226424 months with SCD in one of six centers in Africa. Using the time\u2010averaged maximum of the mean flow velocity, values &lt;170\u00a0cm\/s were considered to be low risk for stroke, 171\u2013199\u00a0cm\/s conditional risk, and &gt;200\u00a0cm\/s high risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 115 children were screened, with five (4.3%) unable to complete the TCD due to agitation. A total of 110 children with a mean age of 15\u00a0\u00b1\u00a05 months were included. Low risk studies were identified in 95 (86.4%) and conditional risk in 15 (13.6%). No patient had a high risk study. Those with conditional risk examinations were not more anemic than those with low risk studies (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.84).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TCD screening of young children with SCD is feasible, with low technical failure rates. Many children in our cohort had a conditional risk study, suggesting cerebral vasculopathy begins at a young age in some African children. Future large cohort studies should be undertaken to determine the incidence of conditional or high risk studies in African children \u22642 years with SCD to inform future guideline development for TCD screening.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31861","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T10:25:14Z","timestamp":1751192714000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Optimizing Transcranial Doppler Screening for Stroke Prevention in Young African Children With Sickle Cell Disease"],"prefix":"10.1002","volume":"72","author":[{"given":"Derby","family":"Tembo","sequence":"first","affiliation":[{"name":"Department of Pediatrics Chipata Central Hospital  Chipata Zambia"},{"name":"University Teaching Hospital Neurology Research Office  Chipata Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Moons","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health Kamuzu University of Health Sciences, Chichiri Blantyre 3  Kamuzu Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taty","family":"Tshimanga","sequence":"additional","affiliation":[{"name":"Departement de Pediatrie Cliniques Universitaires de Kinshasa, Hopital Pediatrique de Kalembe Lembe, Universite De Kinshasa  Kimwenza Lembe Republique Democratic du Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florette Yumsa","family":"Mangwangu","sequence":"additional","affiliation":[{"name":"Departement de Pediatrie Cliniques Universitaires de Kinshasa, Hopital Pediatrique de Kalembe Lembe, Universite De Kinshasa  Kimwenza Lembe Republique Democratic du Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Mayindombe","sequence":"additional","affiliation":[{"name":"Departement de Pediatrie Cliniques Universitaires de Kinshasa, Hopital Pediatrique de Kalembe Lembe, Universite De Kinshasa  Kimwenza Lembe Republique Democratic du Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Tandjeka Ekandji","sequence":"additional","affiliation":[{"name":"Universite des Sciences et des Technologie de Lodja (USTL), L'Hopital General de Reference de Lodja, Lodja  Sankuru District Republique Democratic du Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Pongo","family":"Mbaka","sequence":"additional","affiliation":[{"name":"Universite des Sciences et des Technologie de Lodja (USTL), L'Hopital General de Reference de Lodja, Lodja  Sankuru District Republique Democratic du Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davin Ambitapio","family":"Musungufu","sequence":"additional","affiliation":[{"name":"Centre Medicale Evangelique (CME) Bunia, Bunia  Ituri District Republique Democratic du Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanna","family":"Mwanza","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Chipata Central Hospital  Chipata Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Lupumpaula","sequence":"additional","affiliation":[{"name":"Chipata Central Hospital  Chipata Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet Simanguwa","family":"Chilima","sequence":"additional","affiliation":[{"name":"Chipata Central Hospital  Chipata Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kabemba","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals\u2010Children's Hospital  Nationalist Road Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Nkole","family":"Kafula","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals\u2010Children's Hospital  Nationalist Road Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Chunda\u2010Liyoka","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals\u2010Children's Hospital  Nationalist Road Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tusekile","family":"Phiri","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital, The Blantyre Malaria Project, Blantyre 3  Chichiri Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvester","family":"June","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital, The Blantyre Malaria Project, Blantyre 3  Chichiri Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montfort Bernard","family":"Gushu CO","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital, The Blantyre Malaria Project, Blantyre 3  Chichiri Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Chagaluka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health Kamuzu University of Health Sciences, Blantyre 3  Chichiri Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8826-8671","authenticated-orcid":false,"given":"Nicole F.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Critical Care Medicine Nationwide Children's Hospital The Ohio State University  Columbus Ohio 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