Session Title: Pediatric Rheumatology - Pathogenesis and Genetics
Session Type: Abstract Submissions (ACR)
Background/Purpose: Kawasaki disease (KD) has been reported to have seasonal variations in many different countries, as well as geographical and temporal clustering. It has been found that KD cases diagnosed in Japan, Hawaii and San Diego, USA increase when tropospheric wind patterns arrive from central Asia, suggesting a common, wind-borne causal agent.
Methods: We analyzed KD cases hospitalized in Santiago, Chile to look for associations with local, regional and large scale meteorological variables. We compiled monthly data of KD incidence rates, local meteorological variables, regional winds and several El Niño Southern Oscillation (ENSO) indices for 2001-2010; we considered standardized anomalies in all analyses. We used dynamic linear regression models to account for data autocorrelation.
Results: Zonal (U) winds at 1000 and 925 mb above Santiago show a strong correlation with KD data on univariate linear regression (P<0.001), but no significant association was observed for other unlagged meteorological variables. We then fitted multivariate dynamical regressions using time series ARX models; model selection was carried out by minimizing Akaike‘s Information Criterion (AIC) and several model structures — using different lags in meteorological variables — were explored. This multivariate dynamic regression showed that meteorological variables explain 38% of variance in KD rates. A unit increase in northerly wind at 3 lagged months, temperature at 1 and 3 lagged months and monthly change of ENSO 4 index are associated with changes in KD rates of 0.203 (95% CI 0.049 - 0.358), 0.181 (95% CI 0.014 - 0.347] , 0.192 (95%CI 0.030 - 0.353) and -0.307 (95% CI -0.458 -0.156), respectively.
Conclusion: We found a statistical association of KD at Santiago, Chile with tropospheric, northerly wind patterns suggesting dust transported from the Atacama Desert could include a causative agent. A novel result is that ENSO dynamics also explain part of KD variability with a decrease in KD when La Niña is dissipating or El Niño is on the rise; hence climate scale dynamics might be taken into account in future studies worldwide — at least as a potential explanatory variable that may confound KD seasonality on a global scale.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-kawasaki-disease-with-tropospheric-winds-in-central-chile-is-wind-borne-desert-dust-a-risk-factor/