Transcranial Doppler Screening in Sickle Cell Disease: Insights from a Regional Study in Karnataka, India.

Sickle cell disease (SCD), a hereditary blood disorder in India, disproportionately affects Adivasi communities burdened by socio-economic and systemic inequities. Stroke, a severe complication of SCD, is underexplored in Indian populations, especially among Adivasi groups. This pilot study evaluated the feasibility of transcranial Doppler (TCD) screening in a peripheral healthcare setting in Karnataka, focusing on Adivasi SCD patients. Among 39 participants (27 HbSS, three HbSβ0, nine HbAS) from a hemoglobinopathy registry, none exhibited elevated time-averaged maximum mean (TAMM) velocities, but 73.3% of SCD patients showed unusually low middle cerebral artery (MCA) velocities (<70 cm/s). Significant differences in basilar artery (BA) flow velocities were noted between SCD and sickle cell trait (SCT) patients ( p <0.05), while MCA parameters were comparable. The findings establish baseline TCD velocities and highlight the need for region-specific stroke prevention guidelines tailored to underserved Adivasi populations.