Kawasaki disease in Spanish paediatric population and synoptic weather types: an observational study

Abstract

Kawasaki disease (KD) is a vasculitis of unelucidated pathogenesis that usually occurs in paediatric patients. In this study we analyse the temporal pattern and geographical distribution of the disease in Spain, and its relationship with atmospheric circulation patterns. We performed a retrospective study in which we collected all hospital admissions due to KD in the country between 2005 and 2015 and explored their relationship with demographic and geographical characteristics. Moreover, we calculated daily surface atmospheric patterns over Spain to study the relationship between weather types (WT) and KD Admissions. The average admission rate for KD in the paediatric population was 3.90 per 100,000, with a male to female ratio of 1.56:1. The highest rate of admissions was found in the 0-4-year-old group, with an incidence of 11.7 cases per 100,000. Admissions followed an annual cyclic pattern with a peak of incidence in January (p = 0.022) and a nadir in September. There was an upwards trend in the number of KD admissions in male sex during the study period (p = 0.004). However, there were marked geographical differences in the incidence rate. Finally, the analysis of the relationship between the WT and the number of admissions by KD revealed no statistically significant association. KD admissions follow a peculiar seasonal and spatial distribution, that suggest the involvement of environmental factors in the disease; however, the absence of an association with WT should be interpreted with caution and regional studies should be done to explore this relationship.

Epidemiology of Kawasaki Disease in Europe

“…From 2000 to 2011, KD cases ranged from 30 to 50 per year in Portugal, with a mean of 39 cases per year (35). The (19,27,29). A study performed from 1981 to 2013 in the University hospital of Lausanne in Switzerland described an increase in number of KD cases since 1981.…”

“…These observations underline the importance of the methodology in interpreting results. European studies based on hospital discharge data published in the last 10 years showed annual incidence rates of 9.1–14.7 per 100 000 children under 5 years old ( 19 , 25 , 27 , 28 ), whereas those based on prospective surveillance found lower rates ( 26 , 29 ) ( Table 1 ). A prospective surveillance design in Germany with cross validation with hospital records from two states found that the hospital-based German Pediatric Surveillance Unit (ESPED) missed 37–44% of cases.…”

Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group

“…In Spain, the first population-based study on the epidemiology of KD was published by the KD Catalonian Working Group reporting a mean annual incidence in Catalonia of 3.5/100,000 children <14 years old and 8/100,000 children <5 years (2004–2013)[13]. More recently an incidence of 11.7/100,000 children <5 years has been reported (2005–2015) for the whole of Spain, but this study was a retrospective ecological study and may be overestimating the real incidence[14,15]. Surveillance KD studies are important to monitor trends and outcomes of the disease.…”