Tamara Thomas

Urban Health Today

Not enough children with sickle cell disease (SCD) receive recommendations, treatment, or screening to prevent dangerous disease complications, according to a report by the CDC published on the JAMA network.
In 2014, an expert panel issued guidelines to prevent or reduce complications of SCD in children and adolescents aged 2-16 years. The panel recommended annual ultrasound screening to identify those at risk of stroke and hydroxyurea therapy for individuals ≥9 months old to reduce the risk for several life-threatening complications.
Research also demonstrated the effectiveness of hydroxyurea in preventing or reducing severe pain episodes and other complications of sickle cell anemia and in increased survival.
For this new report, the researchers examined Medicaid records in 2019 of 3352 children and adolescents with sickle cell anemia to see if they had received ultrasound screening, hydroxyurea, or both.
The researchers found that fewer than half (47%) of children aged 2-9 and 38% of children and teens aged 10-16 received ultrasound screening to check blood flow and assess their risk for stroke.
Furthermore, the report revealed that only 38% of children aged 2-9 and 53% of older adolescents used hydroxyurea to reduce severe pain and other complications.
“Our findings highlight the disheartening fact that many young people are not receiving potentially life-saving screenings and treatment for this disease,” said Dr. Laura Schieve of the CDC’s National Center on Birth Defects and Developmental Disabilities and the report’s lead author.
The report listed barriers that contribute to less-than-optimal care for patients with SCD. These barriers include a shortage of clinicians with expertise in treating patients with the disorder, a lack of familiarity with guidelines for ultrasound screening and hydroxyurea use, and logistics issues. Other barriers include the limited availability of appointments for ultrasound screening or the need to travel long distances to radiology centers that perform such screening.
Source: <a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2798234" target="_blank" rel="noopener">JAMA Network</a>

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