Retrospective Descriptive Cross‑Sectional Study of 59 Stroke Cases in Children with Sickle Cell Disease at Two University Hospitals in Yaoundé, Cameroon
Étude Transversale Descriptive Rétrospective de 59 Cas d’AVC chez l’Enfant Drépanocytaire dans Deux Hôpitaux Universitaires de Yaoundé (Cameroun)
DOI:
https://doi.org/10.5281/zenodo.20232692Keywords:
sickle cell disease, stroke, clinical, sequelae, children, YaoundéAbstract
RÉSUMÉ
Introduction. L’accident vasculaire cérébral (AVC) est une complication redoutable de la drépanocytose chez l’enfant, mais son profil clinique et paraclinique reste mal décrit en Afrique subsaharienne. Nous avons mené cette étude pour caractériser les aspects cliniques, radiologiques et évolutifs de l’AVC chez les enfants drépanocytaires à Yaoundé, Cameroun. Méthodes. Nous avons réalisé une étude transversale descriptive avec collecte rétrospective des données sur sept ans (2018‑2024) dans deux hôpitaux universitaires de Yaoundé. Nous avons inclus tous les enfants âgés de 5 à 18 ans, vivant avec une drépanocytose homozygote, hospitalisés pour un AVC (définition OMS). Nous avons exclu les autres étiologies neurologiques et les dossiers incomplets. L’analyse a été purement descriptive (moyennes, écarts‑types, fréquences). Résultats. Sur 1 984 dossiers d’enfants drépanocytaires, nous avons identifié 59 cas d’AVC (incidence hospitalière 2,9 %). L’âge moyen était de 8,5 ± 2 ans (83,1 % avaient moins de 10 ans) ; sex‑ratio fille/garçon de 1,45 (35 filles, 24 garçons). Les premières manifestations de la drépanocytose étaient survenues avant 5 ans chez 79,7 %. Le suivi était irrégulier chez 76,3 % ; seuls 20,3 % prenaient de l’hydroxyurée et 42,4 % une antibioprophylaxie. Le déficit moteur (96,6 %) dominait le tableau neurologique, associé à la fièvre (77,9 %), aux céphalées (69,5 %) et à l’aphasie (33,9 %). Le délai de recours aux soins dépassait 24 heures dans 66,1 % des cas. L’imagerie cérébrale (scanner chez 93,2 %) a montré 76,3 % d’AVC ischémiques, 6,8 % d’hémorragiques et 16,9 % d’imageries normales. L’anémie sévère (hémoglobine < 7 g/dL) concernait 47,5 % des patients. La transfusion a été administrée à 74,6 %. L’évolution a laissé des séquelles motrices chez 52,5 % et la mortalité hospitalière était de 8,5 %. Conclusion. L’AVC chez l’enfant drépanocytaire camerounais survient précocement (avant 10 ans), est principalement ischémique, et laisse des séquelles chez un enfant sur deux. Un suivi régulier, une transfusion préventive et l’hydroxyurée pourraient réduire ce fardeau.
ABSTRACT
Introduction. Stroke is a devastating complication of sickle cell disease in children, yet its clinical and paraclinical profile remains poorly described in sub‑Saharan Africa. We conducted this study to characterize the clinical, radiological, and outcome features of stroke in children with sickle cell disease in Yaoundé, Cameroon. Methods. We performed a descriptive cross‑sectional study with retrospective data collection over seven years (2018‑2024) in two university hospitals in Yaoundé. We included all children aged 5‑18 years with homozygous sickle cell disease hospitalized for stroke (WHO definition). We excluded other neurological etiologies and incomplete records. The analysis was purely descriptive (means, standard deviations, frequencies). Results. Among 1,984 records of children with sickle cell disease, we identified 59 stroke cases (hospital incidence 2.9%). Mean age was 8.5 ± 2 years (83.1% under 10 years); female‑to‑male ratio was 1.45 (35 girls, 24 boys). First sickle cell manifestations occurred before age 5 years in 79.7%. Follow‑up was irregular in 76.3%; only 20.3% received hydroxyurea and 42.4% antibiotic prophylaxis. Motor deficit (96.6%) dominated the neurological presentation, associated with fever (77.9%), headache (69.5%), and aphasia (33.9%). Time to care exceeded 24 hours in 66.1% of cases. Brain imaging (CT in 93.2%) showed ischemic stroke in 76.3%, hemorrhagic in 6.8%, and normal imaging in 16.9%. Severe anemia (hemoglobin <7 g/dL) affected 47.5% of patients. Transfusion was given to 74.6%. Outcome left motor sequelae in 52.5% and in‑hospital mortality was 8.5%. Conclusion. Stroke in Cameroonian children with sickle cell disease occurs early (before age 10 years), is mainly ischemic, and leaves sequelae in one of every two children. Regular follow‑up, preventive transfusion, and hydroxyurea could reduce this burden.
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Copyright (c) 2026 Nguefack Félicitée, Kago-Tague Daniel Armand, Siaka Linda Laure, Tony Nengom Jocelyne, Kouam Mewa Jeannette Euranie, Nguefack Séraphin, Mbassi Awa Hubert Désiré
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