Introduction: Sickle cell disease (SCD) is a major problem in Africa. Among affected children, 50-90% will not attain their first birthday, and 11% have a clinically apparent stroke by 20 years of age. Although the burden of SCD-associated stroke is a significant concern, epidemiological data are lacking in Zambia. Methods: We are undertaking a 12-month, retrospective cohort study of children with SCD and stroke admitted to the University Teaching Hospitals Children’s Hospital in Lusaka, Zambia. Data collection includes demographics, SCD history (age of diagnosis, SCD-specific treatments, number of recent crises), clinical exam finding for stroke localization and any comorbid abnormalities), laboratory (for hemoglobin percentage results when available), therapies provided including antiplately medications, blood transfusions, hydroxyurea, and neuroimaging findings where available. Vascular function determined via transcranial Doppler ultrasonography is available for most patients. Outcomes including death and time from admission to death will be captured. Data is directly entered into REDCap using a tablet and structured abstraction tool. EPI INFO will be used to calculate the period prevalence and conduct an exploratory analysis to identify any demographic, clinical, or laboratory findings associated with inpatient mortality using chi-square tests or student’s t-test with a p-value of <0.05 considered significant with no correction for multiple testing planned given the preliminary nature of this initial work. Results: Preliminary data will be available for presentation before May 2024. Conclusion: This study will provide the fundamental work needed for subsequent case-control studies aimed at determining the risk factors for acute stroke in Zambian children with SCD.

Derby Tembo
University teaching hospitals- Childrens hospital and Chipata Central Hospital and University Teaching Hospital Neurology Research Office

Catherine Chunda
University teaching hospitals-Childrens hospital

Nfwama Kawatu
University teaching hospitals-Childrens hospital

Lisa Nkole
University teaching hospitals-Childrens Hospital

Uzima Chirwa
University teaching hospitals-children hospital

Gretchen L Birbeck
3. University Teaching Hospitals Neurology Research Office, Lusaka, Zambia. 4. Epilepsy Division, Department of Neurology and University of Rochester