Capacity Building for Primary Stroke Prevention Teams in Children Living With Sickle Cell Anemia in Africa.
Capacity Building for Primary Stroke Prevention Teams in Children Living With Sickle Cell Anemia in Africa.
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DOI：
10.1016/j.pediatrneurol.2021.08.010
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发表时间：
2021-12
影响因子：
3.8
通讯作者：
Jordan LC
中科院分区：
文献类型：
--
作者：
Ghafuri DL;Covert Greene B;Musa B;Gambo A;Sani A;Abdullahi S;Wudil BJ;Bello-Manga H;Gambo S;Ghafuri M;Cassell H;Neville K;Kirkham F;Kassim AA;Aliyu MH;DeBaun MR;Jordan LC
尼日利亚是全球镰状细胞性贫血儿童比例最高的国家；估计每年有15万名患有SCA的婴儿出生。SCA患儿的初级卒中预防必须包括尼日利亚。我们结合国家卫生研究院资助的两项初级卒中预防试验（一项可行性试验和三期随机对照试验）描述能力建设战略，对尼日利亚患有SCA和经颅多普勒（TCD）速度异常的儿童进行初步羟基脲治疗。我们预期在低资源环境下与当地团队进行临床试验所面临的挑战，这些团队以前没有参与过临床研究，并寻求一种可持续的初级卒中预防策略。描述性、前瞻性研究的挑战、解决方案和研究团队在两项试验中，共纳入679名SCA儿童。作为试验能力建设部分的一部分，在8年多的时间里，23名研究人员（医生、护士、研究协调员、一名统计学家和药剂师）在美国范德比尔特大学医学中心完成了为期一个月的研究治理和伦理培训项目。每个试验点的一名主要研究协调员完成了临床研究专业人员协会的认证。捐赠TCD机；放射科医生和非放射科医生接受过培训和认证，以执行TCD。采用可扩展的电子处方来跟踪羟基脲治疗。我们与地区政府官员合作，支持正在进行的基于tcd的筛查，并为患有SCA的中风高危儿童提供羟基脲的资助。我们的试验和能力建设展示了在非洲启动和维持儿童SCA初级卒中预防项目的可持续战略。
Nigeria has the highest proportion of children with sickle cell anemia (SCA) globally; an estimated 150,000 infants with SCA are born annually. Primary stroke prevention in children with SCA must include Nigeria. We describe capacity-building strategies in conjunction with two National Institutes of Health-funded primary stroke prevention trials (a feasibility trial and phase III randomized controlled trial) with initial hydroxyurea treatment for children with SCA and abnormal transcranial Doppler (TCD) velocities in Nigeria. We anticipated challenges to conducting clinical trials in a low-resource setting with a local team that had not previously been involved in clinical research and sought a sustainable strategy for primary stroke prevention. Descriptive, prospective study of challenges, solutions, and research teams in two trials that enrolled a total of 679 children with SCA. As part of the capacity-building component of the trials, over eight years, 23 research personnel (physicians, nurses, research coordinators, a statistician and pharmacist) completed a one-month research governance and ethics training program at Vanderbilt University Medical Center, U.S.A. A lead research coordinator for each site completed the Society of Clinical Research Professionals certification. TCD machines were donated; radiologists and non-radiologists were trained and certified to perform TCD. A scalable E-prescription was implemented to track hydroxyurea treatment. We worked with regional government officials to support ongoing TCD-based screening and funding for hydroxyurea for children with SCA at high-risk of stroke. Our trials and capacity-building demonstrate a sustainable strategy to initiate and maintain pediatric SCA primary stroke prevention programs in Africa.
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DOI：
10.1136/amiajnl-2011-000515
发表时间：
2012-05-01
影响因子：
6.4
作者：
Grossman, Joy M.;Cross, Dori A.;Cohen, Genna R.
通讯作者：
Cohen, Genna R.
影响因子：
158.5
作者：
Adams, RJ;McKie, VC;Wiznitzer, M
通讯作者：
Wiznitzer, M
影响因子：
12.8
作者：
Galadanci, Najibah A.;Abdullahi, Shehu Umar;DeBaun, Michael R.
通讯作者：
DeBaun, Michael R.
影响因子：
6.5
作者：
Bello-Manga H;Galadanci AA;Abdullahi S;Ali S;Jibir B;Gambo S;Haliru L;Jordan LC;Aliyu MH;Rodeghier M;Kassim AA;DeBaun MR;Galadanci NA
通讯作者：
Galadanci NA
影响因子：
8.3
作者：
Ichord, Rebecca N.;Bastian, Rachel;Jawad, Abbas F.
通讯作者：
Jawad, Abbas F.