SynthesisArchives of disease in childhood2013
Evidence review of hydroxyurea for the prevention of sickle cell complications in low-income countries.
Synthesis in Archives of disease in childhood, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Impact of the SARS-CoV-2 infection in individuals with sickle cell disease: an integrative review.Frontiers in medicine · 2023Pooled it
- Pooled it
- An assessment of the effectiveness of hydroxyurea therapy in children and adolescents with sickle cell anaemia at Kenyatta National Hospital.Annals of hematology · 2026Article
- Hydroxyurea treatment for sickle cell disease in Nairobi informal settlements: a retrospective cohort study.Frontiers in medicine · 2026Article
- A simplified hydroxyurea dosing approach for paediatric sickle cell anaemia in nigeria: addressing emergency care burden and adherence barriers in low-resource settings.BMC pediatrics · 2025Article
- Review
- Analysis of Causes of Hospitalization Among Children with Sickle Cell Disease in a Group of Private Hospitals in Jeddah, Saudi Arabia.Journal of blood medicine · 2021Article
- The role of hydroxyurea in decreasing the occurrence of vasso-occulusive crisis in pediatric patients with sickle cell disease at King Saud Medical City in Riyadh, Saudi Arabia.Saudi medical journal · 2020Article
- Angelicin-A Furocoumarin Compound With Vast Biological Potential.Frontiers in pharmacology · 2020Review
- Sickle Cell Disease and Infections in High- and Low-Income Countries.Mediterranean journal of hematology and infectious diseases · 2019Review
- Hydroxycarbamide adherence and cumulative dose associated with hospital readmission in sickle cell disease: a 6-year population-based cohort study.British journal of haematology · 2018Observational
- Developing guidelines in low-income and middle-income countries: lessons from Kenya.Archives of disease in childhood · 2017Article
- Hydroxycarbamine: from an Old Drug Used in Malignant Hemopathies to a Current Standard in Sickle Cell Disease.Mediterranean journal of hematology and infectious diseases · 2017Review
- Sickle Cell Disease in Sub-Saharan Africa.Hematology/oncology clinics of North America · 2016Review
- Sickle cell disease.BMJ clinical evidence · 2016Review
- Sickle-cell disease: a call to action.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2015Article
- Hospitalization Events among Children and Adolescents with Sickle Cell Disease in Basra, Iraq.Anemia · 2015Article
- Hashimoto's thyroiditis and acute chest syndrome revealing sickle cell anemia in a 32 years female patient.The Pan African medical journal · 2015Article
- Managing the burden of sickle-cell disease in Africa.The Lancet. Haematology · 2014Article
- Treatment for sickle cell disease in Africa: should we invest in haematopoietic stem cell transplantation?The Pan African medical journal · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Hydroxyurea is widely used in high-income countries for the management of sickle cell disease (SCD) in children. In Kenyan clinical guidelines, hydroxyurea is only recommended for adults with SCD. Yet many deaths from SCD occur in early childhood, deaths that might be prevented by an effective, disease modifying intervention. The aim of this review was to summarise the available evidence on the efficacy, effectiveness and safety of hydroxyurea in the management of SCD in children below 5 years of age to support guideline development in Kenya. We undertook a systematic review and used the Grading of Recommendations Assessment, Development and Evaluation system to appraise the quality of identified evidence. Overall, available evidence from 1 systematic review (n=26 studies), 2 randomised controlled trials (n=354 children), 14 observational studies and 2 National Institute of Health reports suggest that hydroxyurea may be associated with improved fetal haemoglobin levels, reduced rates of hospitalisation, reduced episodes of acute chest syndrome and decreased frequency of pain events in children with SCD. However, it is associated with adverse events (eg, neutropenia) when high to maximum tolerated doses are used. Evidence is lacking on whether hydroxyurea improves survival if given to young children. Majority of the included studies were of low quality and mainly from high-income countries. Overall, available limited evidence suggests that hydroxyurea may improve morbidity and haematological outcomes in SCD in children aged below 5 years and appears safe in settings able to provide consistent haematological monitoring.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.