title: [Kawasaki disease is more prevalent in rural areas of Catalonia (Spain)].
abstract: BACKGROUND
  Kawasaki disease (KD) is an acute self-limited systemic vasculitis relatively common in childhood. The etiology of KD is still unknown, although clinical, laboratory and epidemiological features suggest an infectious origin or trigger. Differences on incidence between countries have been related to specific genetic factors, ethnicity, country of birth and some other sociocultural and environmental factors. We present a population-based study on incidence of KD in Catalonia (Spain), focusing on differences between patients in rural and non-rural areas of the region.
  
  
  METHODS
  Observational population-based study including all Pediatric Units in Catalan hospitals, between 2004 and 2014. A 12-month (March 2013-March 2014) prospective collection of new cases of KD was carried out to determine the incidence of KD. The rest of the data was retrieved retrospectively.
  
  
  RESULTS
  Data from 399 patients over the 10-year study period was analyzed. Among the total KD patients, 353 (88.5%) lived in non-rural areas and 46 (11.5%) in rural areas. It was found that there is a significant difference (P<.001) between the percentage of rural population observed in patients with KD (11.5%), and the expected 5% of the Catalan population.
  
  
  CONCLUSIONS
  This is the first population-based study showing significant differences on KD incidence rates between rural and non-rural areas.
authors.affiliation: Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Parc Taulí, Sabadell, Barcelona, España; Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Sant Joan de Déu , Esplugues de Llobregat, Barcelona, España. Electronic address: jsanchez@tauli.cat.
authors.forename: Judith
authors.initials: J
authors.lastname: Sánchez-Manubens
authors.affiliation: Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Sant Joan de Déu , Esplugues de Llobregat, Barcelona, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Antón
authors.affiliation: Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Sant Joan de Déu , Esplugues de Llobregat, Barcelona, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Bou
authors.affiliation: Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Sant Joan de Déu , Esplugues de Llobregat, Barcelona, España.
authors.forename: Estibaliz
authors.initials: E
authors.lastname: Iglesias
authors.affiliation: Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Sant Joan de Déu , Esplugues de Llobregat, Barcelona, España.
authors.forename: Joan
authors.initials: J
authors.lastname: Calzada-Hernandez
authors.affiliation: Institut Català de Ciències del Clima (IC3), Barcelona, España; ICREA Professor, Climate & Health Program ISGlobal (Barcelona Institute of Global Health), Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Rodó
authors.affiliation: Institut Català de Ciències del Clima (IC3), Barcelona, España.
authors.forename: Josep-Antón
authors.initials: JA
authors.lastname: Morguí
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology*; D015995:Prevalence; D012423:Rural Health; D013030:Spain / Q000453:epidemiology
keywords: Catalonia; Cataluña; Enfermedad de Kawasaki; España; Incidence; Incidencia; Kawasaki disease; Rural areas; Spain; Zonas rurales