KawArabi

The first Retrospective Epidemiology study is underway, with the goal of drawing the best estimate of the prevalence of KD in the Arab world, identifying factors associated with development of coronary complications, and propose solutions to identified culprits. 

This protocol was recently amended to include KD cases encountered since the beginning of COVID-19 pandemic.  The amendment includes MIS-C cases to study the perspective and particularities of this disease in the member countries and institutions. 

Another study aims to perform pharmaco-economic analyses of KD in the aim of providing solid arguments to health authorities with the goal of prioritizing efficient approach of the disease and minimize its burden from the public health perspective.   

The current research protocol has the following UNIFIED OBJECTIVES AND AIMS: 

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To provide a comprehensive understanding of KD and Multisystem Inflammatory Syndrome in Children (MIS-C) in the Arab countries. The unified objectives are as follows:

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Part 1 – Retrospective KD 

1. Estimate the prevalence of KD within different parts of the Arab World and the rate of complications (coronary arteries dilatations, aneurysms, myocardial dysfunction, shock, multisystem failure, coronaries arteries thrombosis, myocardial infarctions and deaths). 

2. Identify factors associated with the development of coronary artery abnormalities (dilation or aneurysms) among participating centers.

3. Assess KD recurrence in Arab countries among children of KD patients and in siblings.

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Part 2 – Retrospective MIS-C 

1. Describe the clinic al presentation, management, and outcomes of MIS-C cases managed in Arab countries since the onset of the COVID-19 pandemic.

2. Compare MIS-C and Kawasaki Disease presentations to identify overlapping features and distinct patterns, enhancing differential diagnosis and management.

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Part 3 – Prospective KD Cohort (Post-2020)

1. Determine the incidence of KD in Arab countries through prospective data collection and compare it with global incidence across different ethnicities. ​To investigate the incidence of KD in Arab ethnicity and compare it with published data on different ethnicities. 

2. To predict genetic predisposition in disease development, we will stratify the cohort into two strata, cases with family consanguinity versus non-consanguineous cases, calculating the risk ratio and the risk difference of the consanguinity on the proportion.

3. To investigate the most predictive risk factors for IVIG resistance and compare results with other populations. We will build a multivariate regression model at the time of data analysis and find the statistically significant variables predicting IVIG resistance and cardiac complications.

The Kawarabi academic activities included various Webinars in the first two years with the perspective to consolidate scientific communication.  We also prioritize face-to-face, in-person meetings such as the initial 4 in-person meetings that took place in Dubai (November 2022), Cairo (October 2023), Dubai (November 2024), and Rabat (April 2024).  These in-person meetings occurred in collaboration with already existing societies or practice annual meeting. This collaboration helped improve attendance at the annual meeting, foster collaboration, increase Kawarabi reach and empower local centers to join Kawarabi.  Above all, these conferences targeted large audience with a specific focus on educating the young generation of physicians.

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Current publications

1. Nait-Ladjemil D et al. Pharmacoeconomic Analysis and Considerations for the Management of Kawasaki Disease in the Arab Countries-A Multinational, Multi-Institutional Project of the Kawasaki Disease Arab Initiative (Kawarabi) (A Project Methodology Paper). Turk Arch Pediatr. 2025 Mar 3;60(2):172-181. doi:  10.5152/TurkArchPediatr.2025.24248.PMID: 40094277 

2. Mohamed M et al. Advancing Kawasaki Disease Research in the Arab World: Scoping Literature Review Analysis with Emphasis on Giant Coronary Aneurysms. Pediatr Cardiol. 2024 Jul 22. doi: 10.1007/s00246-024-03589-4. Online ahead of print. PMID: 39037592 

3. Arab Y et al. Kawarabi: Administrative Structuring of a Multicenter Research Collaborative to Study Kawasaki Disease in the Arab Countries. World J Pediatr Congenit Heart Surg. 2024 Mar;15(2):177-183. doi: 10.1177/21501351231205570. Epub 2023 Nov 19. PMID: 37981829

4. Alzyoud R et al. Access to Care and Therapy for Kawasaki Disease in the Arab Countries: A Kawasaki Disease Arab Initiative (Kawarabi) Multicenter Survey. Pediatr Cardiol. 2023 Aug;44(6):1277-1284. doi: 10.1007/s00246-023-03166-1. Epub 2023 May 1. PMID: 37126143

5. Arab Y et al. Kawasaki Disease Arab Initiative [Kawarabi]: Establishment and Results of a Multicenter Survey. Pediatr Cardiol. 2022 Aug;43(6):1239-1246. doi: 10.1007/s00246-022-02844-w. Epub 2022 May 27. PMID: 35624313 Free PMC article.

6. We are currently finalizing a comprehensive manuscript intended to guide the primary care physician in recognizing the signs and symptoms of Kawasaki disease, assess for risk levels, and prompt work-up and appropriate treatment measures (to be published in a peer-review MEDICAL journal in 2025).