McGann, Patrick TTshilolo, leonSantos, BrigidaTomlinson, George AStuber, SusanLatham, TeresaAygun, BanuObaro, Stephen KOlupot-Olupot, PeterWilliams, Thomas NOdame, IsaacWare, Russell E2026-07-212026-07-212015McGann, P. T., Tshilolo, L., Santos, B., Tomlinson, G. A., Stuber, S., Latham, T., Aygun, B., Obaro, S. K., Olupot‐Olupot, P., Williams, T. N., Odame, I., Ware, R. E., & Investigators, F. T. R. (2015). Hydroxyurea therapy for children with sickle cell anemia in Sub‐Saharan Africa: Rationale and design of the REACH trial. Pediatric Blood & Cancer, 63(1), 98–104. https://doi.org/10.1002/pbc.25705.https://bdears.busitema.ac.ug/handle/123456789/8073Journal ArticleBackground: Sickle cell anemia (SCA) is an inherited hematological disorder that causes a large but neglected global health burden, particularly in Africa. Hydroxyurea represents the only available disease-modifying therapy for SCA, and has proven safety and efficacy in high-resource countries. In sub-Saharan Africa, there is minimal use of hydroxyurea, due to lack of data, absence of evidence-based guidelines, and inexperience among healthcare providers. Procedure: A partnership was established between investigators in North America and sub-Saharan Africa, to develop a prospective multicenter research protocol designed to provide data on the safety, feasibility, and benefits of hydroxyurea for children with SCA. Results: The Realizing Effectiveness Across Continents with Hydroxyurea (REACH, ClinicalTrials.gov NCT01966731) trial is a prospective, phase I/II open-label dose escalation study of hydroxyurea that will treat a total of 600 children age 1–10 years with SCA: 150 at each of four different clinical sites within sub-Saharan Africa (Angola, Democratic Republic of Congo, Kenya, and Uganda). The primary study endpoint will be severe hematological toxicities that occur during the fixed-dose treatment phase. REACH has an adaptive statistical design that allows for careful assessment of toxicities to accurately identify a safe hydroxyurea dose. Conclusions: REACH will provide data that address critical gaps in knowledge for the treatment of SCA in sub-Saharan Africa. Keywords: Africa; hydroxyurea; sickle cell anemiaenArticle