Kawasaki disease: two case reports from the Aga Khan Hospital, Dar es Salaam-Tanzania

Abstract

BackgroundKawasaki disease is a common childhood vasculitis which may result in cardiovascular morbidity if not adequately treated. Its epidemiology in the African region is not well described. Its features may mimic other childhood infections and hemoglobinopathies and it is rarely diagnosed in the East African region. These are the first reports of this disease from Tanzania.Case presentationWe present two cases of complete Kawasaki disease seen over a 2 year period and diagnosed as per the criteria defined by the American Heart Association. One child was and infant and the other a 3 year old. Both of them presented with a prolonged fever and mucocutaneous findings. None of the children developed coronary artery aneurysms. One was treated with aspirin alone and the other with both aspirin and intravenous immunoglobulin. Both children had complete recovery and did not have any cardiovascular sequelae.ConclusionKawasaki disease may be more common in the East African region than previously thought. It should be considered as a differential diagnosis in children who present with a prolonged fever of greater than 5 days and mucocutaneous findings. More awareness about this condition, its epidemiology, diagnosis and management are required in order to prevent the cardiovascular morbidity associated with it.

Spectrum of paediatric rheumatic disorders at a tertiary hospital in Tanzania

“…Kawasaki disease, Takayasu arteritis and IgA vasculitis were observed in this study, our findings which are consistent with reports from India, South Africa and Kenya and demonstrate existence of these rare rheumatic disorder in Tanzania [7,13,16,26]. Kawasaki disease has been previously described from Tanzania in a case report by Noorani et al [11] Interesting Olaosebikan et al did not find any case of vasculitis in a study conducted in Nigeria [8].…”

“…One of the two participants with vasculitis had IgA vasculitis. From these findings it is evident that different paediatric rheumatic conditions are common Tanzania, this was also depicted in the previous case reports from Tanzania [11,12]. The pattern of rheumatic disorders presented by this study break the myths that these conditions are not existing in the region, and in fact some conditions like SLE are reported to be more common among people of African descent [19].…”

“…Two case reports have been published documenting existence of paediatric rheumatic conditions in Tanzania. Noorani et al described two cases of Kawasaki Diseases who were managed at one of hospital in Tanzania while Grijsen et al described a four-year-old girl who presented with dermatomyositis [11,12]. The lack of information on the burden of rheumatic disorders among children in Tanzania prompted this study to be carried out at Muhimbili National Hospital.…”

Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study

“…Kawasaki disease is rarely reported in sub-Saharan Africa, but it might be more common than previously thought. 33 In the United Kingdom and the United States, a 2.5-fold higher incidence was reported in children of Asian ancestry than of European ancestry, with an intermediary 1.5-fold risk for children of African ancestry. 34 35 Besides, African-Americans have been disproportionately affected by the covid-19 pandemic, also suggesting an increased susceptibility to severe SARS-CoV-2 infection.…”

Do low TB prevalence and lack of BCG Vaccinations Contribute to Emergence of Multisystem Inflammatory Syndrome in Children?

“…(KD) is an acute febrile systemic vasculitis that predominantly occurs in children younger than 5 years of age and the most common acquired heart disease during childhood in most industrialized countries 7 and is the most common primary vasculitis in childhood, with medium and small sized arteries predominantly affected 8 . The annual incidence of KD is highest in Japan, with more than 300 per 100 000 children aged 4 years or younger affected 9 , compared with 25 per 100 000 children aged 5 years or younger in North America 10 and is rarely reported in sub-Saharan Africa 11 . Although KD is less common in western countries 12 KD shock syndrome ( KDSS) a rare form of KD has a higher incidence in these countries 13 (2.60 to 6.95%) 14,12,15 ,compared with Asian countries like Taiwan which reported lower incidence rate (1.45%) 16 .…”