Access to Care and Therapy for Kawasaki Disease in the Arab Countries: A Kawasaki Disease Arab Initiative (Kawarabi) Multicenter Survey:

Author:

Alzyoud Raed1,El-Kholy Nermeen2,Arab Yousra3,Choueiter Nadine4,Harahsheh Ashraf S.5,Aselan Adnan Salem6,Kotby Alyaa7,Bouaziz Asma8,Salih Aso F.9,Abushhaiwia Awatif10,Alahmadi Fahad11,Agha Hala M.12,Elmarsafawy Hala M.13,Alrabte Hanifa14,Al-Saloos Hesham15,Boudiaf Houda16,Hijazi Issa17,Bouayed Kenza18,Senaidi Khalfan Salim Al19,Boughammoura Lamia20,Jalal Maryam18,Ladj Mohamed S.21,Abu-Shukair Mohammed E.22,Ganzoury Mona M. El7,Hammadouche Nacera21,Elsamman Nora23,Mouawad Pierre24,Boukari Rachida25,Benalikhoudja Nassiba25,Jd Salima14,Al-Saoud Sima Y. Abu26,Touri Soued Nabila27,Kammoun Thouraya28,Fitouri Zohra29,Dahdah Nagib30

Affiliation:

1. Chief of Pediatric Allergy, Immunology and Rheumatology Divsion, Queen Rania Children’s Hospital

2. Mirdif Private Hospital

3. Université de Sherbrooke

4. Icahn School of Medicine at Mount Sinai

5. Cardiology, Department of Pediatrics, Children’s National Hospital; George Washington University School of Medicine & Health Sciences

6. Pediatric cardiologist, Madinah Maternity and Children Hospital, King Salman Medical City

7. Pediatric cardiology division, Department of Pediatrics, Faculty of Medicine, Ain Shams University

8. Headmaster of children and Neonatal Department, Hôpital Régional

9. HD Cardiology, Pediatric Cardiology Department, Children's Heart Hospital, Sulaimani College of medicine, Sulaimani University

10. Pediatric Rheumatology Department, Tripoli Children’s Hospital

11. King Faisal Specialist Hospital and Research Center, Pediatric Cardiology, Taibah University

12. Pediatric Cardiology Division, Cairo University

13. Pediatric Cardiology division, Children Hospital, Mansoura University

14. Pediatric Cardiology Department, Tripoli Children’s Hospital

15. Division of Cardiology, Sidra Medicine, Clinical Pediatrics, Weill Cornell Medicine

16. Onco-pediatric Department, University Hospital Mustapha Bacha, Algiers University

17. Cardiology Center, King Hussein Medical Center

18. A. Harouchi, Mother and Child Hospital, CHU Ibn Rochd

19. Division of Pediatric Cardiology, Sultan Qaboos University Hospital

20. Pediatric Department of Farhat Hached Hospital, Faculté de Médecine de Sousse

21. Pediatric Department, Djillali Belkhenchir University Hospital, Faculty of Medicine, Algiers University

22. JO-PAIR CLINIC, Saudi Hospital

23. Pediatric Cardiology, Pediatrics Department, Ain Shams University

24. Pediatric Department, Saint George Hospital University Medical Center

25. Pediatric Department University Hospital, Mustapha Bacha

26. Department of Pediatrics, Makassed Hospital, Al- Quds University, Faculty of Medicine

27. Pediatric Department, University Hospital

28. Pediatric Department of Hedi Chakar Hospital,Faculté de Médecine de Sfax

29. Unit of Rheumatology, Emergency and Outpatient Department, Pediatric Hospital of Béchir Hamza of Tunis. University Tunis El Manar

30. Division of Pediatric Cardiology, CHU Ste-Justine, Université de Montréal.

Abstract

Abstract 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.

Publisher

Research Square Platform LLC

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