Transcranial Doppler in Screening of Sickle Cell Disease in Basrah: A Cross-sectional Descriptive Study

Basim A.A  Alhijaj; Wissam J.  Yeser; Huda M.  Othafa

doi:10.18502/fbt.v12i2.18270

Basim A.A Alhijaj Consultant Pediatrician, Head of Basrah Center for Hereditary Blood Disease, Al Zahraa Medical College, IAMRS Secretary, Basrah, Iraq
Wissam J. Yeser Specialist Radiologist, Al-Basrah Center for Hereditary Blood Diseases, Basrah Teaching Hospital, Basrah, Iraq
Huda M. Othafa Specialist Radiologist, Al-Basrah Center for Hereditary Blood Diseases, Basrah Teaching Hospital, Basrah, Iraq

DOI: https://doi.org/10.18502/fbt.v12i2.18270

Keywords: Transcranial Doppler; Time-Averaged Mean Maximum; Sickle Cell Disease; Stroke.

Abstract

Purpose: This cross-sectional study aimed to assess the effectiveness of Transcranial Doppler (TCD) screening as a primary preventive measure against overt strokes in sickle cell patients at the Basrah Center for Hereditary Blood Diseases. The study's objectives were to analyze descriptive statistics of enrolled patients and investigate potential correlations between TCD values and various factors, such as age, sex, mean hemoglobin levels, and High-Performance Liquid Chromatography (HPLC) domains.

Materials and Methods: TCD screening was introduced at the Basrah Center for Hereditary Blood Diseases in 2012, utilizing an imaging ultrasonic machine. Four years later, it transitioned to a non-imaging technique, significantly expanding the service. The screening was carried out by two specially trained senior radiologists, resulting in more than 300 annual examinations.

Results: Among the enrolled patients, no abnormal TCD values (above 200) were recorded. However, 23 patients exhibited conditional values (170-200), with a higher prevalence among males and homozygous SCA individuals. These patients had a mean Hb F of 18.2%, Hb S of 70.2%, a mean age of 8.9 years, and an Hb level of 7.45 gm/dL.

Conclusion: Transcranial Doppler screening at Basrah Center for Hereditary Blood Diseases has proven effective in preventing overt strokes in sickle cell patients. The absence of abnormal TCD values in the enrolled patients suggests that early intervention and monitoring through TCD can be a valuable tool in managing sickle cell disease. Further analysis revealed potential associations between conditional TCD values and specific factors, such as age, sex, mean hemoglobin levels, and HPLC domains, which warrant continued investigation for a better understanding of risk factors in sickle cell patients.