Guía

WHO consolidated guidelines for the management of common childhood illness: management of sickle-cell disease in children and adolescents

Año de publicación

2026

Institución emisora

World Health Organization

Enlaces

WHO IRIS

Recomendaciones

15 recomendaciones incluidas

In children and adolescents (aged 0–19 years) with suspected sickle-cell disease (SCD), the use of lateral flow immunoassay and micro-engineered haemoglobin electrophoresis point-ofcare tests (POCTs) is suggested for diagnosis in settings where standard laboratory-based haemoglobin fractionation or DNA-based tests are not available.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Baja

In children aged less than 5 years with sickle-cell disease (SCD), prophylactic penicillin (oral or intramuscular (IM)) is suggested to prevent pneumococcal infection, including in those who have received age-appropriate pneumococcal vaccination.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Baja

In children aged older than 5 years with sickle-cell disease (SCD) who have completed pneumococcal vaccination series and do not have additional risk factors, such as prior invasive pneumococcal infection or history of surgical splenectomy, prophylactic penicillin is not recommended.

Estado

Nueva

Recomendado en contra

Condicional

Certeza de la evidencia

Baja

In children aged older than 5 years with sickle-cell disease (SCD), who have not completed pneumococcal vaccination series, or who have a history of splenectomy or prior invasive pneumococcal infection, prophylactic penicillin is suggested, regardless of vaccination status.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Baja

In children and adolescents (aged 9 months to 19 years) with sickle-cell anaemia (SCA), hydroxyurea therapy is recommended regardless of clinical severity.

Estado

Nueva

Recomendado a favor

Fuerte

Certeza de la evidencia

Baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD), experiencing acute painful crises, the use of non-steroidal anti-inflammatory drugs (NSAIDs) is suggested for initial pain management.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Muy baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD), the use of non-steroidal anti-inflammatory drugs (NSAIDs) in combination with opioids is suggested for the management of moderate to severe acute pain, rather than opioids alone.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD), the use of opioids alone is suggested for acute pain management rather than paracetamol plus opioids.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Muy baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD), regular (chronic) blood transfusion with iron chelation therapy is suggested for the management of recurrent pain

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Muy baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD) and a clinical diagnosis of acute chest syndrome (ACS), the use of antibiotics in addition to standard therapeutic and supportive interventions is suggested.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD) and a clinical diagnosis of acute chest syndrome (ACS), blood transfusion in combination with standard therapeutic interventions is suggested rather than standard therapeutic interventions alone.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Muy baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD) and suspected acute symptomatic stroke, exchange transfusion is suggested rather than simple red blood cells (RBC) transfusion.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Muy baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD) at risk of recurrent stroke (e.g. history of stroke, haemoglobin S >30% and haemoglobin <9 g/dL), regular blood transfusion with iron chelation therapy is suggested rather than hydroxyurea therapy alone for secondary stroke prevention.

Estado

Nueva

Recomendado a favor

Condicional

Certeza de la evidencia

Muy baja

In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD) who have no symptoms of pulmonary hypertension, routine echocardiogram screening to detect pulmonary hypertension is not suggested.

Estado

Nueva

Recomendado en contra

Condicional

Certeza de la evidencia

Baja

In children and adolescents (aged 2–16 years) with sickle-cell anaemia (SCA) and no prior abnormal transcranial Doppler (TCD) results, annual TCD ultrasound screening is recommended for primary prevention of stroke.

Estado

Nueva

Recomendado a favor

Fuerte

Certeza de la evidencia

Muy baja