Étude de onze nouveaux cas congolais de maladie de Kawasaki

Babéla, Jean Robert Mabiala; Ikobo, L.C. Ollandzobo; Nika, R. E.; Moyen, G.

doi:10.1007/s13149-015-0445-2

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…In our study, four cases of KD were identified over a one year period, which is comparable, or a bit higher, than a few of the larger African case series in the literature [14–16]. Rheumatic fever is still the most common cause of acquired cardiac disease in children in developing countries [17] yet in this study, only one case of rheumatic fever was admitted.…”

Section: Discussionsupporting

confidence: 51%

The spectrum of rheumatic in-patient diagnoses at a pediatric hospital in Kenya

et al. 2017

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BackgroundPediatric rheumatic diseases are chronic illnesses that can cause considerable disease burden to children and their families. There is limited epidemiologic data on these diseases in East Africa. The aim of this study was to assess the spectrum of pediatric rheumatic diagnoses in an in-patient setting and determine the accuracy of ICD-10 codes in identifying these conditions.MethodsMedical records from Gertrude’s Children’s Hospital in Kenya were reviewed for patients diagnosed with “diseases of the musculoskeletal system and connective tissue” as per ICD-10 diagnostic codes assigned at discharge between January and December 2011. Cases were classified as “rheumatic” or “non-rheumatic”. Accuracy of the assigned ICD-10 code was ascertained. Death records were reviewed. Longitudinal follow-up of “rheumatic” cases was done by chart review up to March 2014.ResultsTwenty six patients were classified as having a “rheumatic” condition accounting for 0.32% of patients admitted. Of these, 11 (42.3%) had an acute inflammatory arthropathy, 6 (23.1%) had septic arthritis, 4 (15.4%) had Kawasaki disease, 2 (7.7%) had pyomyositis, and there was one case each of septic bursitis, rheumatic fever, and a non-specific soft tissue disorder. No cases of juvenile idiopathic arthritis (JIA) were identified. One case of systemic lupus erythematosus was documented by death records. The agreement between the treating physician’s discharge diagnosis and medical records ICD-10 code assignment was good (Kappa: 0.769). On follow-up, one child had recurrent knee swelling that was suspicious for JIA.ConclusionsPediatric rheumatic conditions represented 0.32% of admissions at a pediatric hospital in Kenya. Acute inflammatory arthropathies, septic arthritis and Kawasaki disease were the most frequent in-patient rheumatic diagnoses. Chronic pediatric rheumatic diseases were rare amongst this in-patient population. Despite limitations associated with the use of administrative diagnostic codes, they can be a first step in evaluating the spectrum of pediatric rheumatic conditions in Kenya and other countries in East Africa.

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Section: Discussionsupporting

confidence: 51%

The spectrum of rheumatic in-patient diagnoses at a pediatric hospital in Kenya

et al. 2017

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“…The reports from North Africa make up 86.3% of the published African cases. The largest reports, outside of North Africa, include 8 cases (1987–1988) from Johannesburg, South Africa [ 19 ], 8 (2011–2016) from Lagos, Nigeria [ 53 ], 11 (2003–2014) from Brazzaville, Democratic Republic of the Congo [ 43 ] and 33 (2014–2021) from Libreville, Gabon [ 81 ]. The case series from Gabon included 2 years from the COVID-19 pandemic and it is unclear how many of the cases presented were in that 2-year period and whether they had been exposed to COVID-19 [ 81 ].…”

Section: Discussionmentioning

confidence: 99%

“…In our KD cases, the mean fever duration was 8.3 days (SD+/-4.7) (range 2–20). Mabiala and co-workers, in their case series from Democratic Republic of the Congo, also found that patients had prolonged fever on admission (mean 12.8 days; range 6–30) [ 43 ]. In a large series from Algeria of 133 patients, Boudiaf et al proposed that the long duration of fever (13 ± 6 days) related to a marked delay in diagnosis of KD from the referral centers to their public tertiary care hospital [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

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Kawasaki disease in Kenya and review of the African literature

Migowa,

Njeru,

Were

et al. 2024

Pediatr Rheumatol

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Background 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.

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“…A Congolese study reported on a case series of 11 patients with KD seen between 2003 and 2014, of which nine of these cases were classified as complete Kawasaki disease. The male to female sex ratio was 2.7 with a mean age of 16.5 ± 5.9 months with a range of between 9 and 43 months [ 20 ]. A review of 26 in-patients with a rheumatological diagnosis in a Kenyan pediatric hospital found that 4 patients (15.4%) had Kawasaki disease [ 21 ].…”

Section: Medium-vessel Vasculitismentioning

confidence: 99%

Vasculitis in Africa

2018

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Purpose of ReviewSystemic vasculitides are characterized by inflammation of blood vessel walls leading to a myriad of organ disorders depending on the size, site, and location of the affected blood vessel. The epidemiology of vasculitis in the developing world has been inadequately documented. The description of the vasculitides in Africa, both from hospital series as well as taking into consideration, previous epidemiological studies in the community, indicates that these conditions have been rare until relatively recently. In view of these past observations, this review of publications on the topic looks to shed light on the current state of vasculitis in Africa.Recent FindingsTakayasu and Kawasaki appear to be the most commonly reported vasculitides in Africa. Most of the published reports are from North and South Africa. Furthermore, the contribution of vasculitis associated with infections, and in particular HIV, is significant.SummaryThere are increasing numbers of publications reflecting a growing recognition of the vasculitides in Africa.

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Étude de onze nouveaux cas congolais de maladie de Kawasaki

Cited by 5 publications

References 17 publications

The spectrum of rheumatic in-patient diagnoses at a pediatric hospital in Kenya

The spectrum of rheumatic in-patient diagnoses at a pediatric hospital in Kenya

Kawasaki disease in Kenya and review of the African literature

Vasculitis in Africa

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