Neurologic complications of sickle cell disease in Africa
Neurologic complications of sickle cell disease in Africa
复制标题
非洲镰状细胞病的神经系统并发症
作者：
J. Noubiap;M. Mengnjo;Nicolas Nicastro;Joseph Kamtchum
目的：总结非洲镰状细胞病（SCD）神经系统并发症的患病率数据。方法：我们检索了EMBASE、PubMed和African Index Medicus，以识别从成立到2016年5月31日发表的所有相关文章。对每项研究的方法学质量进行了审查。采用随机效应模型估计各研究中SCD神经系统并发症的患病率。结果：共纳入31项研究。在90%的研究中，方法学质量为高或中等。卒中、条件性和异常脑血流、癫痫发作和头痛是最常报告的并发症，总体患病率分别为4.2%、10.6%、6.1%、4.4%和18.9%。一些并发症，如无症状性脑梗死、周围神经病变、神经认知缺陷或烟雾病，在非洲很少或根本没有研究。发病率数据很少，质量也很差。结论：SCD神经系统并发症的负担在非洲很重要，很可能被低估。更好地评估这种负担需要更大规模的前瞻性研究，使用标准的最新筛选方法。在常规临床实践中，应改善获得神经成像、经颅多普勒、脑电图和神经心理学评估等诊断工具以及预防和治疗干预措施和训练有素的卫生保健提供者的机会。
Objective: To summarize prevalence data on the neurologic complications of sickle cell disease (SCD) in Africa. Methods: We searched EMBASE, PubMed, and African Index Medicus to identify all relevant articles published from inception to May 31, 2016. Each study was reviewed for methodologic quality. A random-effects model was used to estimate the prevalence of neurologic complications of SCD across studies. Results: Thirty-one studies were included. Methodologic quality was high or moderate in 90% of studies. Stroke, conditional and abnormal cerebral blood flow, seizures, and headache were the complications most frequently reported, with overall prevalence rates of 4.2%, 10.6%, 6.1%, 4.4%, and 18.9%, respectively. Some complications, like silent brain infarcts, peripheral neuropathies, neurocognitive deficits, or moyamoya disease, have been rarely or not studied at all in the African setting. Incidence data were scarce and of poor quality. Conclusions: The burden of neurologic complications of SCD is important in Africa and most likely underestimated. A better evaluation of this burden requires larger prospective studies using standard up-to-date screening methods. Accessibility to diagnostic tools such as neuroimaging, transcranial Doppler, EEG, and neuropsychological evaluation, as well as to preventive and therapeutic interventions and trained health care providers, should be improved in routine clinical practice.
使用羟基脲治疗患有镰状细胞病的尼日利亚儿童中风复发。
DOI：
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发表时间：
2013
期刊：
The Nigerian postgraduate medical journal
影响因子：
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作者：
Lagunju,IA;Brown,BJ;Sodeinde,OO
通讯作者：
Sodeinde,OO