Translating research to usual care of children with sickle cell disease in Northern Nigeria: lessons learned from the SPRING Trial Team.

Translating research to usual care of children with sickle cell disease in Northern Nigeria: lessons learned from the SPRING Trial Team.
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DOI:
10.1186/s13104-021-05885-1
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发表时间:
2022-01-04
期刊:
影响因子:
1.8
通讯作者:
King AA
King AA
中科院分区:
其他
文献类型:
--
作者:
Bello-Manga H;Haliru L;Tabari AM;Farouk B;Suleiman A;Bahago GY;Sani AM;Bauman AA;DeBaun MR;King AA

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高收入国家预防卒中的循证实践包括筛查经颅多普勒(TCD)血流速度异常,并开始定期输血至少1年,然后用羟基脲治疗。这种做法还没有转移到像尼日利亚这样的低资源环境中,尼日利亚是全球SCD人口密度最高的国家。在北方尼日利亚的SCA儿童中进行多中心随机对照试验后,在临床试验中心和其他地点将卒中筛查和开始使用羟基脲确定为标准治疗。我们的目的是描述我们在尼日利亚SCA中风预防研究转化为实践的关键步骤。在PRISM框架的指导下,我们描述了我们如何将镰状细胞贫血儿童卒中一级预防的随机对照试验结果转化为卡杜纳,尼日利亚SCA儿童的常规护理。这项研究的结果表明,从临床试验开始的组织支持和利益相关者参与的重要性。具有进行疗效试验的双重目标,同时专注于未来实施的策略,可以显着减少发现和常规实践之间的滞后时间。
Evidence-based practice for stroke prevention in high-income countries involves screening for abnormal transcranial Doppler (TCD) velocity and initiating regular blood transfusions for at least 1 year, followed by treatment with hydroxyurea. This practice has not been transferred to low-resource settings like Nigeria, the country with the highest global population density of SCD. Following a multi-center randomized controlled trial among children with SCA in northern Nigeria, screening for stroke and initiation of hydroxyurea was established as standard of care at the clinical trial sites and other locations. We aim to describe the critical steps we took in translating research into practice for stroke prevention in SCA in Nigeria. Guided by the PRISM framework, we describe how we translated results from a randomized controlled trial for primary prevention of stroke in children with sickle cell anemia into usual care for children with SCA in Kaduna, Nigeria. Findings from this study demonstrate the importance of organizational support and stakeholder involvement from the onset of a clinical trial. Having the dual objective of conducting an efficacy trial while simultaneously focusing on strategies for future implementation can significantly decrease the lag time between discovery and routine practice.
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