Sickle Cell Disease

To the Editor: The review of sickle cell disease by Piel et al. (April 20 issue) 1 is timely and highlights the need to address the lack of research about this disease in sub-Saharan Africa. The authors rightly state that in the past two decades, childhood mortality has been reduced in sub-Saharan Africa, but the survival data cited by Piel et al. were derived from a single-site study performed almost four decades ago. 2 Two-year follow-up data from a pilot cohort study in Nigeria (Table 1) show that survival among children with sickle cell disease remains poor in sub-Saharan Africa. 3 There are . . .