Pediatric Grand Rounds (RECORDING) Global strategies for sickle cell disease

This presentation is a recording of a Stanford Pediatric Grand Rounds Session.  World-renowned experts will present the latest research, practice guidelines, and treatment protocols to advance best practices in the care of pediatric patients. These online recordings will provide pediatricians and family physicians with up-to-date clinical information on a wide range of clinical issues encountered in daily pediatric practice. 

In this session, Dr. Russell Ware, of Cincinnati Children's Hospital Medical Center, discusses the crushing burden of sickle cell disease on children, as well as current global efforts for treatment, surveillance and future strategies.  

  Release Date: June 15, 2022
  Expiration Date: June 14, 2023
  Estimated Time to Complete: 1.0 hours 
  Registration Fee: FREE
 *Originally recorded 04/01/2022.

1. Discuss the pathophysiology of sickle cell disease.
2. Describe the global burden of sickle cell disease.
3. List opportunities for meaningful global health research in sickle cell disease.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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References/Bibliography

Ambrose, E. E., Smart, L. R., Charles, M., Hernandez, A. G., Latham, T., Hokororo, A., Beyanga, M., Howard, T. A., Kamugisha, E., McElhinney, K. E., Tebuka, E., & Ware, R. E. (2020). Surveillance for sickle cell disease, United Republic of Tanzania. Bulletin of the World Health Organization, 98(12), 859–868. https://doi.org/10.2471/BLT.20.253583

Herrick, J. B. (1910). Peculiar elongated and sickle-shaped red blood corpuscles in a case of severe anemia. The Journal of the American Medical Association. https://doi.org/10.1001/archinte.1910.00050330050003

John, C. C., Opoka, R. O., Latham, T. S., Hume, H. A., Nabaggala, C., Kasirye, P., Ndugwa, C. M., Lane, A., & Ware, R. E. (2020). Hydroxyurea Dose Escalation for Sickle Cell Anemia in Sub-Saharan Africa. The New England journal of medicine, 382(26), 2524–2533. https://doi.org/10.1056/NEJMoa2000146

Liu, L., Johnson, H. L., Cousens, S., Perin, J., Scott, S., Lawn, J. E., Rudan, I., Campbell, H., Cibulskis, R., Li, M., Mathers, C., Black, R. E., & Child Health Epidemiology Reference Group of WHO and UNICEF. (2012). Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet (London, England), 379(9832), 2151–2161. https://doi.org/10.1016/S0140-6736(12)60560-1

McGann, P. T. et al. (2015). An accurate and inexpensive color-based assay for detecting severe anemia in a limited-resource setting. American Journal of Hematology, vol. 9 (12:1122-27). https://doi.org/10.1002/ajh.24180

McGann, P. T., Ferris, M. G., Ramamurthy, U., Santos, B., de Oliveira, V., Bernardino, L., & Ware, R. E. (2013). A prospective newborn screening and treatment program for sickle cell anemia in Luanda, Angola. American journal of hematology, 88(12), 984–989. https://doi.org/10.1002/ajh.23578

McGann, P. T., Grosse, S. D., Santos, B., de Oliveira, V., Bernardino, L., Kassebaum, N. J., Ware, R. E., & Airewele, G. E. (2015). A Cost-Effectiveness Analysis of a Pilot Neonatal Screening Program for Sickle Cell Anemia in the Republic of Angola. The Journal of pediatrics, 167(6), 1314–1319. https://doi.org/10.1016/j.jpeds.2015.08.068

McGann, P. T., Schaefer, B. A., Paniagua, M., Howard, T. A., & Ware, R. E. (2016). Characteristics of a rapid, point-of-care lateral flow immunoassay for the diagnosis of sickle cell disease. American journal of hematology, 91(2), 205–210. https://doi.org/10.1002/ajh.24232

Ndeezi, G., Kiyaga, C., Hernandez, A. G., Munube, D., Howard, T. A., Ssewanyana, I., Nsungwa, J., Kiguli, S., Ndugwa, C. M., Ware, R. E., & Aceng, J. R. (2016). Burden of sickle cell trait and disease in the Uganda Sickle Surveillance Study (US3): a cross-sectional study. The Lancet. Global health, 4(3), e195–e200. https://doi.org/10.1016/S2214-109X(15)00288-0

Opoka, R. O., Ndugwa, C. M., Latham, T. S., Lane, A., Hume, H. A., Kasirye, P., Hodges, J. S., Ware, R. E., & John, C. C. (2017). Novel use Of Hydroxyurea in an African Region with Malaria (NOHARM): a trial for children with sickle cell anemia. Blood, 130(24), 2585–2593. https://doi.org/10.1182/blood-2017-06-788935

Piel, F. B., Hay, S. I., Gupta, S., Weatherall, D. J., & Williams, T. N. (2013). Global burden of sickle cell anaemia in children under five, 2010-2050: modelling based on demographics, excess mortality, and interventions. PLoS medicine, 10(7), e1001484. https://doi.org/10.1371/journal.pmed.1001484

Piel, F. B., Patil, A. P., Howes, R. E., Nyangiri, O. A., Gething, P. W., Williams, T. N., Weatherall, D. J., & Hay, S. I. (2010). Global distribution of the sickle cell gene and geographical confirmation of the malaria hypothesis. Nature communications, 1, 104. https://doi.org/10.1038/ncomms1104

Quinn, C. T., Rogers, Z. R., McCavit, T. L., & Buchanan, G. R. (2010). Improved survival of children and adolescents with sickle cell disease. Blood, 115(17), 3447–3452. https://doi.org/10.1182/blood-2009-07-233700

Schaefer, B. A., Kiyaga, C., Howard, T. A., Ndeezi, G., Hernandez, A. G., Ssewanyana, I., Paniagua, M. C., Ndugwa, C. M., Aceng, J. R., & Ware, R. E. (2016). Hemoglobin variants identified in the Uganda Sickle Surveillance Study. Blood advances, 1(1), 93–100. https://doi.org/10.1182/bloodadvances.2016000950

Smart, L. R., Ambrose, E. E., Raphael, K. C., Hokororo, A., Kamugisha, E., Tyburski, E. A., Lam, W. A., Ware, R. E., & McGann, P. T. (2018). Simultaneous point-of-care detection of anemia and sickle cell disease in Tanzania: the RAPID study. Annals of hematology, 97(2), 239–246. https://doi.org/10.1007/s00277-017-3182-8

Tegha, G., Topazian, H. M., Kamthunzi, P., Howard, T., Tembo, Z., Mvalo, T., Chome, N., Kumwenda, W., Mkochi, T., Hernandez, A., Ataga, K. I., Hoffman, I. F., & Ware, R. E. (2021). Prospective Newborn Screening for Sickle Cell Disease and Other Inherited Blood Disorders in Central Malawi. International journal of public health, 66, 629338. https://doi.org/10.3389/ijph.2021.629338

Tshilolo, L., Tomlinson, G., Williams, T. N., Santos, B., Olupot-Olupot, P., Lane, A., Aygun, B., Stuber, S. E., Latham, T. S., McGann, P. T., Ware, R. E., & REACH Investigators. (2019). Hydroxyurea for Children with Sickle Cell Anemia in Sub-Saharan Africa. The New England journal of medicine, 380(2), 121–131. https://doi.org/10.1056/NEJMoa1813598

Ware, R. E. (2010). How I use hydroxyurea to treat young patients with sickle cell anemia. Blood, 115(26), 5300–5311. https://doi.org/10.1182/blood-2009-04-146852

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Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Member Information

Role in activity

Nature of Relationship(s) / Name of Ineligible Company(s)

Alan R. Schroeder, MD
Clinical Professor
Stanford University

Co-Course Director and Reviewer

Nothing to disclose

Russell E Ware, MD, PhD
Director, Division of Hematology, Institute Co-Executive Director, Cancer and Blood Diseases Institute, Director, Global Health Center, Marjory J. Johnson Chair of Hematology Translational Research, Professor, UC Department of Pediatrics
Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine

Faculty

Grant or research support-Bristol-Myers Squibb|Grant or research support-Addmedica|Grant or research support-Hemex Health|Advisor-Nova Laboratories|Membership on Advisory Committees or Review Panels, Board Membership, etc.-Novartis AG|Membership on Advisory Committees or Review Panels, Board Membership, etc.-Editas

Debra Babcock, MD
Stanford Childrens (PCHA)

Planner

Nothing to disclose

Caitlin Billingham, MD, MPH
Chief Resident
Stanford Pediatrics

Planner

Nothing to disclose

Lisa Jo Chamberlain, MD
Professor of Pediatrics – General Pediatrics
Stanford Children's Health

Planner

Nothing to disclose

Olivera Marsenic Couloures, MD
LPCH

Planner

Nothing to disclose

Lane Donnelly, MD
University of North Carolina

Planner

Nothing to disclose

Baraka Dechelle Floyd, MD
Clinical Assistant Professor and Associate Chair for Diversity, Equity, and Inclusion
Stanford University School of Medicine

Planner

Nothing to disclose

Ingrid Garnica, Other
Stanford Pediatrics

Planner

Nothing to disclose

Charles Gawad, MD, PhD
Associate Professor
Stanford

Planner

Ownership-BioSkryb Genomics

Allison Guerin, EdD
Stanford

Planner

Nothing to disclose

Mary Beth Leonard, MSCE, MD, MSCE
Arline and Pete Harman Professor and Chair, Department of Pediatrics
Stanford University

Planner

Nothing to disclose

Stephen J Roth, MPH, MD
Attending, Cardiovascular ICU
Lucile Packard Children's Hospital Stanford

Planner

Nothing to disclose

Sarina Tom, BA
Education Operations Manager
Stanford Pediatrics

Planner

Nothing to disclose

Ke-You Zhang, MD
Stanford University

Planner

Nothing to disclose