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43 INNOSC Theranostics and Pharmacological Sciences, 2023, Vol. 6, No. 1 Hariharan
care in the African countries. Availability, SCA patients in lower- and lower middle-income
accessibility, and affordability of the diagnostic regions. Diagnostic and intervention packages
and therapeutic care in Europe may improve targeting these patients should be developed and
the survival of the patients, thereby showing a implemented by clinicians across the high-risk
comparatively higher prevalence in the region. settings. Further studies on exploring the factors

Hence, there is a need to close the gap in providing responsible for high burden of PHT among
care for the SCA patients between Europe and SCA patients should be done as it will help the
Africa. This calls for the development of simple, clinicians to understand the mechanism and take
non-invasive, and cost-effective tools for screening decisive actions and implement patient-specific
the patients, as it ultimately leads to early diagnosis interventions accordingly.
and adequate management of the condition. Using
right heart catheterization as a screening tool is not Acknowledgments
practically possible due to lack of trained/skilled None.
human resources in such low-income/high-SCA-
burden countries in Africa. TRV screening can be Funding
considered a more pragmatic option for screening
the SCA patients for PHT in such settings. There is None.
also availability of many biomarkers that suggest
the presence of PHT and can be used as an effective Conflict of interest
screening tool [54]. The author declares no conflicts of interests.
The major strength of the study is that this is
so far the first comprehensive review on burden Author contributions
of PHT among the younger population with SCA
globally. We have also included large number This is single-authored manuscript.
of studies to provide reasonable estimate on Ethics approval and consent to participate
the burden. However, our review had certain
limitations. All the included studies have used Not applicable.
TRV to diagnose PHT. This can overestimate the
prevalence as the right heart catheterization is the Consent for publication
gold standard for diagnosing a case of PHT. The
Chi-square test for heterogeneity also revealed Not applicable.
significant variability across the included studies. Availability of data
This limitation was overcome in this work by
conducting meta-regression to explain the between- Not applicable.
study variability using meta-regression and identify
the potential sources of heterogeneity. Significant References
publication bias was also found, indicating that the [1] World Health Organization. Sickle-Cell Disease and Other
point estimate obtained in our review should be Haemoglobin Disorders WHO, Geneva. Available from: https://
interpreted with caution. apps.who.int/iris/bitstream/handle/10665/20890/A59_9-en.
pdf?sequence=1&Isallowed=y [Last accessed on 2022 Feb 11].
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Available from: https://www.afro.who.int/health-topics/sickle-
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