Kawasaki disease in Kenya and review of the African literature

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dc.contributor.authorMigowa, A.
dc.contributor.authorNjeru, CM.
dc.contributor.authorWere, E.
dc.contributor.authorNgwiri, T.
dc.contributor.authorColmegna, I.
dc.contributor.authorHitchon, Carol A
dc.contributor.authorScuccimarri, R.
dc.date.accessioned2024-05-08T16:18:39Z
dc.date.available2024-05-08T16:18:39Z
dc.date.issued2024-04-14
dc.date.updated2024-05-01T16:16:45Z
dc.description.abstractBackground Kawasaki disease has been described across the globe, although publications from Africa are limited. To our knowledge, there are no publications on Kawasaki disease from Kenya, which triggered this report. Methods A retrospective cross-sectional study was undertaken to identify in-patients with a discharge diagnosis of Kawasaki disease, over 2 different 5-year periods, at two pediatric hospitals in Nairobi, Kenya. We reviewed the medical records of all patients and report their clinical findings, diagnostic workup and treatment. In addition, we undertook a detailed review of the literature. Results Twenty-three patients with Kawasaki disease were identified, of those 12 (52.2%) had incomplete disease. The mean age was 2.3 years (SD+/-2.2) (range 0.3–10.3) with a male to female ratio of 1:1. The mean duration of fever at diagnosis was 8.3 days (SD+/-4.7) (range 2–20). Oral changes were the most common clinical feature and conjunctivitis the least common. Thrombocytosis at diagnosis was seen in 52% (12/23). Twenty-one patients (91.3%) were treated with intravenous immunoglobulin and all except 1 received aspirin. Baseline echocardiograms were performed in 95.7% (22/23) and found to be abnormal in 3 (13.6%). Follow-up data was limited. Our literature review identified 79 publications with documented cases of Kawasaki disease in children from 22 countries across the African continent with a total of 1115 patients including those from this report. Only 153 reported cases, or 13.7%, are from sub-Saharan Africa. Conclusions This is the first publication on Kawasaki disease from Kenya and one of the largest reports from sub-Saharan Africa. It is the first to have a complete review of the number of published cases from the African continent. Challenges in the diagnosis and management of Kawasaki disease in many African countries include disease awareness, infectious confounders, access and cost of intravenous immunoglobulin, access to pediatric echocardiography and follow-up. Increasing awareness and health care resources are important for improving outcomes of Kawasaki disease in Africa.
dc.identifier.citationPediatric Rheumatology. 2024 Apr 14;22(1):43
dc.identifier.doi10.1186/s12969-024-00977-1
dc.identifier.urihttp://hdl.handle.net/1993/38216
dc.language.isoeng
dc.language.rfc3066en
dc.publisherBMC
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.subjectKawasaki Disease
dc.subjectVasculitis
dc.subjectPediatric Rheumatology
dc.subjectAfrica
dc.subjectKenya
dc.subjectGlobal Health
dc.titleKawasaki disease in Kenya and review of the African literature
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Internal Medicine
oaire.citation.issue43
oaire.citation.titlePediatric Rheumatology
oaire.citation.volume22
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