Diretriz

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

Ano de publicação

2026

Instituição emissora

World Health Organization

Links

Recomendações

15 recomendações incluídas

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa

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.

Status

Nova

Recomendado contra

Condicional

Certeza da evidência

Baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa

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

Status

Nova

Recomendado a favor

Forte

Certeza da evidência

Baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

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

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

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.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

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.

Status

Nova

Recomendado contra

Condicional

Certeza da evidência

Baixa

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.

Status

Nova

Recomendado a favor

Forte

Certeza da evidência

Muito baixa