Advancing Kawasaki Disease Research in the Arab World: Scoping Literature Review Analysis with Emphasis on Giant Coronary Aneurysms

Mariam Mohamed, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
Ashraf Harahsheh, Division of Cardiology Department of PediatricsSchool of Medicine & Health Sciences, Children's National Hospital, The George Washington University, Washington, USA.
Nadine Choueiter, Icahn School of Medicine at Mount Sinai, New York, USA.
Hala M. Agha, Pediatric Cardiology Division, Cairo University, Giza, Egypt.
Hanifa Alrabte, Pediatric Cardiology Department, Tripoli Children Hospital, Tripoli, Libya.
Sima Y. Abu Al-Saoud, Department of Pediatrics, Faculty of Medicine, Makassed Hospital, Al-Quds University, Jerusalem, Palestine.
Hesham Al-Saloos, Division of Cardiology, Sidra Medicine, Clinical Pediatrics, Weill Cornell Medicine, Ar-Rayyan, Qatar.
Khalfan Al Senaidi, Division of Pediatric Cardiology, Sultan Qaboos University Hospital, Muscat, Oman.
Raed Alzyoud, Pediatric Immunology, Allergy, and Rheumatology Division, Queen Rania Children's Hospital, Amman, Jordan.
Zainab Al Awadhi, Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates.
Reda Belbouab, Faculty of Medicine, Pediatric Department University Hospital, Mustapha Bacha Algiers, Algiers University, Algiers, Algeria.
Kenza Bouayed, Abderrahim Harouchi Mother-Child Hospital, CHU Ibn Rochd, Casablanca, Morocco.
Asma Bouaziz, Headmaster of Children and Neonatal Department, Hôpital Régional Ben Arous, Ben Arous, Tunisia.
Mona El Ganzoury, Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Zohra Fitouri, Division of Rheumatology, Emergency Department of Béchir Hamza Pediatric Hospital of Tunis, Tunis, Tunisia.
Alyaa Kotby, Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Mohamed S. Ladj, Department of Pediatrics, Faculty of Medicine, Djillali Belkhenchir University Hospital, Algiers University, Algiers, Algeria.
Mohammed Mokhtar Bekkar, Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, CHU Oran, Oran University, Oran, Algeria.
Najat Rugige, Pediatric Cardiology Department, Benghazi Children Hospital, Benghazi University, Benghazi, Libya.
Aso Faeq Salih, Pediatric Cardiology Department/Children's Heart Hospital, Sulaimani College of Medicine-Sulaimani University, Al-Sulaimaniyah, Iraq.
Mohamed Sulaiman, KidsHeart Medical Center, Abu-Dhabi, United Arab Emirates.
Nagib Dahdah, Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Canada. Nagib.dahdah.med@ssss.gouv.qc.ca.

Document Type

Journal Article

Publication Date

7-22-2024

Journal

Pediatric cardiology

DOI

10.1007/s00246-024-03589-4

Keywords

Giant coronary aneurysm; MIS-C; Middle East; North-Africa

Abstract

To evaluate giant aneurysms (GiAn) prevalence in Arab countries and examine contributing factors; and to review Kawasaki disease (KD) publication trends and collaborations among Arab nations. A scoping literature review was conducted to analyze the publications across the Arab world, spanning 16 countries from 1978 to 2023. The collected articles were a combination of database search with a call on Kawasaki Disease Arab Initiative (Kawarabi) members to share non-PubMed publications. Over 45 years, 50 articles originated from the Arab Countries with a 30% average annual growth rate in KD research output. Publications were evenly split between case reports (42%) and institutional series (52%). Research productivity lagged in developing nations with UAE, KSA and Egypt, contributed to 64% of total publications. Among 26 institutional series, 256 coronary artery aneurysms (CAA) from a total of 1264 KD cases were reported. Of those, 25 CAA were GiAn (prevalence 1.43% [range 0-12.5%]). The initial KD misdiagnosis rate was 4%, and incomplete KD (iKD) averaged 10.6%. Series (38.5%) that did not report iKD correlated with a higher prevalence of CAA, but not of GiAn. Longer fever duration emerged as a pivotal factor for GiAn (OR 5.06, 95%CI 1.51-17). This review unveils the research landscape of KD in the Arab world over 45 years. Initial misdiagnosis, untreated cases, delayed diagnosis and underreporting of iKD are contributing factors for an underestimated epidemiology, explaining the higher GiAn prevalence. This calls for strategic interventions to enhance KD research in these countries, aligning with Kawarabi's mission.

Department

Pediatrics

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