Risk Factor of Cerebral Vasculopathy in Children with Sickle Cell Disease in Madagascar

Introduction: Sickle cell disease is a genetic disease that is common in Madagascar with serious complications.The cerebral vasculopathies are among the most dreadful complications by its morbid mortalities.In Madagascar, these cerebral vasculopathies in children with sickle cell disease are not sufficiently studied, and the risk factors are still unknown, hence the goal of our study. Methods:We conducted a case-control multi-center study over a 24-month period (from March 2016 to March 2018), on children with sickle cell of 2 months to 15-years-old.Results: Sixty-four children were included with 32 cases and 32 matched controls by age.Twenty-nine cases had clinical cerebral vasculopathy with stroke, and 3 had accelerated cerebral arterial velocities with TCD ≥ 200 cm/s.The risk factors found were leukocytosis p = 0.014 IC 95% OR 3.63(1.27-10.37),thrombocytosis p = 1.9e-05IC 95% OR 10.35 (2.5-42.3)and a regular influenza vaccination p = 0.02 IC 95% OR 0.16 (0.04-0.7). Conclusion:The cerebral vasculopathies of sickle cell children are complications that can be easily prevented if the risk factors are identified.