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Previous Volume 329:501-502 August 12, 1993 Number 7 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Physicians in developing countries who treat patients with sickle cell disease have traditionally relied heavily on clinical judgment. The combination of the high prevalence of the disorder and the limited diagnostic and therapeutic facilities available means that only treatments based on incontestable clinical evidence are feasible. When a patient is febrile or markedly anemic, treatment has to be largely empirical, with reliance on antibiotics or blood transfusion. Clinical compromises are inevitable, and doctors face the harsh discipline of deciding which treatments are really justified by the available data. By contrast, doctors working in more privileged circumstances can afford to be . . . [Full Text of this Article]

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