Use of hydroxyurea in French-speaking Sub-Saharan Africa Recommendations of the scientific council of Drep.Afriq

A large number of scientific studies advocate for the widespread use of hydroxyurea (HU) in Africa because they have shown a very significant reduction in crises, the need for red blood cell transfusions and the mortality of treated sickle cell patients. However, limited access to the drug, particularly due to the cost for families or supply disruptions, makes it difficult to generalise it in 2025 in practice. To our knowledge, there are no recommendations on the prescription of HU in this particular socio-economic context in French-speaking countries. The scientific council of Drep.Afrique, composed of equal numbers of African and French specialists in the disease ( https://www.drep-afrique.org/equipe/ ), proposes here a pragmatic consensus adapted to the conditions on the ground through answers to three essential questions: which patients to treat? (and especially who not to forget to treat?); at what dose?; with what monitoring schedule? These recommendations concern children and adults with sickle cell disease (homozygous SS or S/ß0-thalassemia). Ideally, the indication should be discussed with a sickle cell specialist. This advice can be taken remotely and should not delay the prescription of the drug for the most serious cases.

“ Use of hydroxyurea in French-speaking Sub-Saharan Africa”.

We attach the link to the French version of these recommendations: GuidelineDrepafrique as well as the link to the article in English (free download) https://link.springer.com/article/10.1007/s00277-024-06180-2#MOESM2

The Drép.Afrique scientific council https://www.drep-afrique.org/equipe/

Jean-Benoît ARLET

Doctor, researcher, France

Coordinator of the scientific council of Drep.Afrique

Françoise BERNAUDIN

Doctor, researcher, France.

Anne CORBASSON

Nurse, France.

Binta COULIBALY

Pharmacist, France.

Charlotte EPOSSE EKOUBE

Doctor, researcher, Cameroon.

Mariane de MONTALEMBERT

Doctor, researcher, France

Ibrahima DIAGNE

Doctor, researcher, Senegal.

Dapa DIALLO

Doctor, researcher, Mali.

Saliou DIOP

Doctor, researcher, Senegal.

Frederic GALACTEROS

Doctor, researcher, France.

Olivier HERMINE

Doctor, researcher, France.

Eleonore KAFANDO

Doctor, researcher, Burkina Faso.

Brigitte RANQUE

Doctor, researcher, France

Leon TSHILOLO

Doctor, researcher, DR Congo.

Constant VODOUHÊ

Researcher, Benin.

Ahoefa VOVOR

Doctor, researcher, Togo