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Clinical Trial
. 2022 Jan 1;44(1):e56-e61.
doi: 10.1097/MPH.0000000000002179.

Establishing Sickle Cell Disease Stroke Prevention Teams in Africa is Feasible: Program Evaluation Using the RE-AIM Framework

Djamila L Ghafuri  1 , Shehu U Abdullahi  2 , Abdu H Dambatta  3 , Jamil Galadanci  4 , Musa A Tabari  5 , Halima Bello-Manga  6 , Nura Idris  5 , Hauwa Inuwa  2 , Aliyu Tijjani  2 , Aisha A Suleiman  5 , Binta W Jibir  7 , Safiya Gambo  7 , Awwal I Gambo  7 , Yusuf Khalifa  8 , Lawal Haliru  9 , Sani Abdulrasheed  9 , Mohammed A Zakari  10 , Brittany C Greene  1 , Edwin Trevathan  11 , Lori C Jordan  12 , Muktar H Aliyu  13 , Ana A Baumann  14 , Michael R DeBaun  1
Affiliations
Clinical Trial

Establishing Sickle Cell Disease Stroke Prevention Teams in Africa is Feasible: Program Evaluation Using the RE-AIM Framework

Djamila L Ghafuri et al. J Pediatr Hematol Oncol. .

Erratum in

Abstract

We used the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to evaluate a Stroke Prevention Team's readiness to prevent strokes in children with sickle cell anemia living in northern Nigeria. The NIH sponsored Stroke Prevention Trial in Nigeria included a goal of a sustainable stroke prevention program. The program's 1-year reach for transcranial Doppler screening was 14.7% (4710/32,000) of which 6.0% (281/4710) had abnormal velocities (≥200 cm/s). All participants with abnormal transcranial Doppler velocities were started on hydroxyurea (effectiveness). The leaders of all 5 hospitals agreed to adopt the program. After 1 year, program-implementation and maintenance rates were 100%, demonstrating the program's feasibility and short-term sustainability.

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Conflict of interest statement

M.R.D.: had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. M.R.D.: designed the study. S.U.A. and M.A.T.: provided the TCD training. A.H.D., H.B.-M., H.I., A.T., A.A.S., B.W.J., S.G., Y.K., L.H., S.A., M.A.Z., and N.I.: administered the TCD screening. E.T. and L.J.: verified the neurological examinations. A.I.G., F.M.U., M.A.T., A.I.G., S.U.A., B.C.G., J.G., and D.L.G.: collected the data. D.L.G. and M.R.: performed the analyses. M.R.D., S.A., D.L.G., A.A.B., M.R.D.: interpreted the results. D.L.G., A.A.B., L.C.J., E.T., M.H.A., and M.R.D.: wrote the manuscript. Before submission, all authors reviewed the manuscript.The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Performance of Sickle Cell Disease Stroke Prevention Team program on individual Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) dimensions, combined from 5 hospitals in Kano and 1 hospital in Kaduna, Nigeria. SCA indicates sickle cell anemia.
FIGURE 2
FIGURE 2
Flow diagram describing: (1) Program Reach defined as the proportion of children followed in the sickle cell disease clinics at the 5 hospitals receiving transcranial Doppler (TCD) screening as standard care; and (2) Program Effectiveness, defined as the number of children with abnormal TCD velocities at risk for an initial stroke who initiated hydroxyurea treatment as a form of primary stroke prevention, at the 4 hospitals in Kano and 1 hospital in Kaduna, Nigeria. SCA indicates sickle cell anemia.
See this image and copyright information in PMC

References

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