Mohamed Mariam, Harahsheh Ashraf, Choueiter Nadine, Agha Hala M, Alrabte Hanifa, Abu Al-Saoud Sima Y, Al-Saloos Hesham, Al Senaidi Khalfan, Alzyoud Raed, Al Awadhi Zainab, Belbouab Reda, Bouayed Kenza, Bouaziz Asma, El Ganzoury Mona, Fitouri Zohra, Kotby Alyaa, Ladj Mohamed S, Bekkar Mohammed Mokhtar, Rugige Najat, Salih Aso Faeq, Sulaiman Mohamed, Dahdah Nagib
Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
Division of Cardiology Department of PediatricsSchool of Medicine & Health Sciences, Children's National Hospital, The George Washington University, Washington, USA.
Pediatr Cardiol. 2024 Jul 22. doi: 10.1007/s00246-024-03589-4.
To evaluate giant aneurysms (GiAn) prevalence in Arab countries and examine contributing factors; and to review Kawasaki disease (KD) publication trends and collaborations among Arab nations. A scoping literature review was conducted to analyze the publications across the Arab world, spanning 16 countries from 1978 to 2023. The collected articles were a combination of database search with a call on Kawasaki Disease Arab Initiative (Kawarabi) members to share non-PubMed publications. Over 45 years, 50 articles originated from the Arab Countries with a 30% average annual growth rate in KD research output. Publications were evenly split between case reports (42%) and institutional series (52%). Research productivity lagged in developing nations with UAE, KSA and Egypt, contributed to 64% of total publications. Among 26 institutional series, 256 coronary artery aneurysms (CAA) from a total of 1264 KD cases were reported. Of those, 25 CAA were GiAn (prevalence 1.43% [range 0-12.5%]). The initial KD misdiagnosis rate was 4%, and incomplete KD (iKD) averaged 10.6%. Series (38.5%) that did not report iKD correlated with a higher prevalence of CAA, but not of GiAn. Longer fever duration emerged as a pivotal factor for GiAn (OR 5.06, 95%CI 1.51-17). This review unveils the research landscape of KD in the Arab world over 45 years. Initial misdiagnosis, untreated cases, delayed diagnosis and underreporting of iKD are contributing factors for an underestimated epidemiology, explaining the higher GiAn prevalence. This calls for strategic interventions to enhance KD research in these countries, aligning with Kawarabi's mission.
评估阿拉伯国家巨大动脉瘤（GiAn）的患病率并研究相关影响因素；回顾川崎病（KD）的发表趋势及阿拉伯国家之间的合作情况。开展了一项范围界定文献综述，以分析1978年至2023年期间阿拉伯世界16个国家的相关出版物。收集的文章是数据库检索与呼吁川崎病阿拉伯倡议（Kawarabi）成员分享非PubMed出版物的结合。在45年的时间里，有50篇文章来自阿拉伯国家，KD研究产出的年均增长率为30%。病例报告（42%）和机构系列研究（52%）的出版物数量相当。发展中国家的研究生产力滞后，阿联酋、沙特阿拉伯和埃及的出版物占总数的64%。在26个机构系列研究中，共报告了1264例KD病例中的256例冠状动脉瘤（CAA）。其中，25例CAA为GiAn（患病率1.43%[范围0 - 12.5%]）。KD的初始误诊率为4%，不完全KD（iKD）平均为10.6%。未报告iKD的系列研究（38.5%）与CAA的较高患病率相关，但与GiAn无关。发热持续时间延长是GiAn的一个关键因素（OR 5.06，95%CI 1.51 - 17）。本综述揭示了45年来阿拉伯世界KD的研究情况。初始误诊、未治疗病例、诊断延迟和iKD报告不足是导致流行病学被低估的因素，这解释了GiAn患病率较高的原因。这就需要采取战略干预措施，以加强这些国家的KD研究，这与Kawarabi的使命相一致。
