138 - INCIDENCE OF KAWASAKI DISEASE AT CHANDIGARH, NORTH INDIA DURING 2015-2019 – THE UPWARD TREND CONTINUES

Background: There is a paucity of literature on epidemiological data on Kawasaki disease (KD) from developing countries. The present study aims to estimate the incidence of KD during the period 2015-2019 at Chandigarh, North India.

Methodology: All children suffering from KD residing within the Union Territory [UT] of Chandigarh and diagnosed between January 2015-December 2019 were enrolled. Annual incidence rates were calculated using decadal growth rates based on National Census Data, 2011. The methodology was similar to the two previously published studies from our center pertaining to 1994-2008, and 2009-2014. We computed the incidence of KD in children aged < 5 and children aged < 15 years. We also undertook linear trend and prediction analyses using Holt-Winter's Additive Smoothing technique for KD cases < 5 years and < 15 years.

Results: During 2015-2019, 83 patients (66 boys, 17 girls) below 5 were identified to have KD in UT Chandigarh. Annual incidence rates during this 5-year period were 5.64, 9.25, 9.11, 9.87, and 9.72/100,000 in children below 5 and 2.65, 4.44, 3.86, 5.07, 4.74/100,000 in children below 15. There was an increasing incidence of disease from 2015-2019. The mean age at diagnosis was 61 months (median=48 months; range: 12 days - 15 years). There is a 53.1% increase in the annual incidence of KD in children below 5 and a 53.7% increase in children below 15 from 2015-2019, compared to our previous data from 2009-2014. Coronary artery abnormalities (CAAs) during the acute phase of illness were noted in 17.7% of patients, while at 6 weeks of illness, 7.6% of patients with KD had persistent CAAs. Trend analysis found a monthly rise of 0.02 cases among children below 5 and 0.0165 cases among children below 15, (p-value < 0.0001). This forecast predicts a monthly increase of 0.0177 cases of KD among children aged 0-15 years during the period from 2020 to 2030.

Conclusions: This study highlights that the incidence of KD in Chandigarh has continued to show an upward trend over the period 2005-2019. This may reflect a true increase in KD incidence or may be due to increased ascertainment of disease due to increased awareness amongst pediatricians and physicians in this region. Despite treatment, CAAs were documented in 17.7% of patients with KD during the acute phase of the disease. KD appears to be emerging as an important cause of acquired heart disease in children in North India.