Kawasaki syndrome in Jamaica.
OBJECTIVE
To determine the epidemiology, management and outcome of Kawasaki syndrome in patients presenting to the major referral centers in Jamaica (population, 2.5 million) from May, 1986, through June, 1998.


METHODS
Retrospective review of all cases of Kawasaki syndrome in major referral centers island wide. American Heart Association diagnostic criteria were used in case definition. Demographic, clinical diagnostic and laboratory data, management and outcome findings were analyzed.


RESULTS
Of 98 probable cases 57 were diagnosed with definite Kawasaki syndrome. The average annual incidence was 2.7 per 100,000 children in the 0- to 5-year age group, in a predominantly black population. Eighty-one percent of cases were from the Kingston Metropolitan area (population, 800,000). Children in the first 3 years of life were represented by 67% of cases, with a mean age of presentation of 32 months (range, 5 to 120 months). There was a male preponderance (M:F ratio, 1.71:1). The mean time between onset of illness and diagnosis was 9.1 days (SD 3.9 days). The most common presenting clinical features included fever, anorexia, vomiting, conjunctivitis, exanthema and oropharyngeal and peripheral extremity changes (>45% of patients). Only 7 children received treatment with intravenous gamma-globulin. Overall 38.8% of patients had cardiovascular changes and 28% had coronary artery abnormalities. Girls (8 of 21, 38.1%) were significantly more likely to have coronary changes than boys (8 of 36, 28.5%) [P < 0.05]. Two (3.5%) patients experienced a recurrence.


CONCLUSIONS
There is a tendency for late recognition and, hence, failure of treatment of Kawasaki syndrome in Jamaica. Greater awareness of the condition needs to be implemented. The finding of female children with an increased occurrence of coronary abnormalities warrants further investigation.
Pierre
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Section of Child Health, University of the West Indies, Mona, Kingston, Jamaica. rptrin@cwjamaica.com
Sue-Ho
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Watson
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D
D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies