Studies on Kawasaki disease (KD) in Arab countries are scarce, often providing incomplete data. This along with the benefits of multicenter research collaboratives led to the creation of the KD Arab Initiative [Kawarabi] consortium. An anonymous survey was completed among potential collaborative Arab medical institutions to assess burden of KD in those countries and resources available to physicians. An online 32-item survey was distributed to participating institutions after conducting face validity. One survey per institution was collected. Nineteen physicians from 12 countries completed the survey representing 19 out of 20 institutions (response rate of 95%). Fifteen (79%) institutions referred to the 2017 American Heart Association guidelines when managing a patient with KD. Intravenous immunoglobulin (IVIG) is not readily available at 2 institutions (11%) yet available in the country. In one center (5%), IVIG is imported on-demand. The knowledge and awareness among countries’ general population was graded (0 to 10) at median/interquartiles (IQR) 3 (2–5) and at median/IQR 7 (6–8) in the medical community outside their institution. Practice variations in KD management and treatment across Arab countries require solid proactive collaboration. The low awareness and knowledge estimates about KD among the general population contrasted with a high level among the medical community. The Kawarabi collaborative will offer a platform to assess disease burden of KD, among Arab population, decrease practice variation and foster population-based knowledge. Supplementary Information The online version contains supplementary material available at 10.1007/s00246-022-02844-w.
Background. Sensorineural hearing loss after procedures including extracorporeal circulation and hypothermia is greater than general population. Mild hypothermia has a protective role on cochlea; however, deep hypothermia may result in cochlear injury. This research aimed at assessing auditory function in children after open heart surgery in relation to different hypothermic techniques. Subjects and Methods. Forty children with acyanotic heart diseases who underwent open heart surgery were included: group I: twenty patients subjected to mild hypothermia (33° to 37°C), group II: twenty patients subjected to moderate hypothermia (28° to 32°C). Audiological assessment included basic evaluation and otoacoustic emissions. Results. Both groups had distortion-product otoacoustic emissions (DPOAEs) amplitude >3 dB SPL at all frequencies. However, group II showed lower amplitude at overall and at high frequencies (4.416–8.837 KHz) than group I. Transient evoked otoacoustic emissions (TEOAEs) showed partial pass in three patients of group I (15%) and in 15 patients of group II (75%). Moreover, group II showed statistical significant reduction in overall TEOAEs amplitude as well as at high frequencies (2–4 KHz). Conclusions. Patients exposed to moderate hypothermic technique had subtle cochlear dysfunction. Otoacoustic emissions should be used for early detection of subtle cochlear dysfunction in operated cardiac children.
Kawasaki Disease (KD) is still the most common acquired heart disease in children below the age of five years; it has been well described in the developed world; however, data from the Arab world are limited to case reports or single-center case series. In an effort of optimizing KD research in the Arab world, a group of physicians and researchers established the KD Arab Initiative (Kawarabi) in 2021, and published the first survey, which showed disparities in the availability of intravenous immunoglobulin (IVIG); this had prompted Kawarabi to assess the access to care and therapy of KD patients in Arab countries. A 32 structured questions survey was conducted in thirteen Arab countries and addressed KD patients’ access to healthcare in urban and rural settings. The survey results showed that access to care was uniform across large, mid-size cities and rural areas in 7/13 (54%) countries, while in 6/13 (46%) countries, it was in favor of large and mid-size cities over rural areas. The quality of medical services received by children with KD in large cities was rated as excellent in 6/13 or good in 7/13 countries compared to fair in 4/13 or poor in 4/13 countries in rural areas. Availability of IVIG was limited (23%) in mid-size cities and almost impossible (23%) in rural areas. The KD patients in mid-size cities and rural areas have limited access to standard healthcare in the Arab world. This survey laid the foundation for future Kawarabi endeavors to improve the care of children with KD.
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