ABSTRACT OF MASTER’S DISSERTATION
No. 1
CourseMasters in TropicalMedicine

Name

Aden Kay Celis-SeposoThesis

Incidence of Kawasaki Disease in Children in the Philippines, its

Title

Seasonality, and Association with Ambient Air Temperature

Background:
Kawasaki Disease (KD) is a systemic febrile illness with unknown etiology thatmostly affects children under 5 years old. While literature regarding KD epidemiology
have been steadily increasing, studies regarding its temporal variability, in thecontext of seasonality, as well as the role of temperature have been scarce. Inaddition, studies in tropical countries have been limited, especially in the Philippines.
Hence, providing new insight on the up-to-date KD epidemiology, its seasonality,and its association with ambient air temperature in the Philippines would better equip
both practitioners and health policymakers alike for subsequent response.

Objectives:
This study aimed to describe the KD incidence in children in the Philippines, assess
its seasonality, and determine its association with ambient air temperature.

Methods:
An ecological study design was utilized for this study. Our main outcome wasmonthly KD cases obtained from the Philippine Pediatric Society (PPS) disease
registry, whereas the main exposure, ambient air temperature, was obtained fromthe National Oceanic and Atmospheric Administration (NOAA). The epidemiology ofKD in the Philippines with age-specific and year-specific incidence rates from 2009
to 2019 were reflected in the summary statistics. We then used a generalized linear
model (GLM) with quasi-Poisson regression to assess the seasonality of KD anddetermine its association with ambient air temperature after adjusting for the relevant
confounders.
*The abstract, containing background, objectives, methods, results and conclusion should not exceed 300500words and printed double sided on A4 paper).

ABSTRACT OF MASTER’S DISSERTATION
No. 2Course

Masters in TropicalMedicine

Name

Aden Kay Celis-Seposo

Results:
A total of 6483 KD cases were recorded from January 2009 to December 2019, with3332 (51.4%) cases belonging to 1 to 4 years old age group, and 3831 (59%) cases
were male (male:female ratio of 1.44:1). Mean incidence rate was 3.71 cases per
100,000 population of children under 5 years old from 2009 to 2019, with the highestincidence (4.83 cases per 100,000 population of <5 years old) in the year 2017. The
rate of annual increase of incidence is 0.14 (p=0.01, 95% confidence interval [95%CI]: 1.04-1.27) during the study period. It was also noted that there was a unimodal
shape of seasonal pattern of KD cases in children with its estimated highest numberof cases occurring during month of March and its lowest during month of September.
After adjusting for seasonality and long-term trend, it was noted for every one-degree
Celsius increase, the monthly mean temperature was significantly associated withmonthly KD cases (Relative Risk [RR]: 1.08, 95% CI: 1.02-1.15). Furthermore,monthly mean temperature during the dry season (December to May) was positively
associated with monthly KD cases (RR: 1.06, 95% CI: 1.01-1.11), while there was
no evidence of an association during the wet season (June to November) (RR=1.10,95% CI 0.95-1.27).

Conclusion:
Kawasaki disease incidence rate in children in the Philippines though small inmagnitude, has increased through the years. Also, KD was noted to have a unimodal
seasonal variation with its peak of cases in March and nadir in September. Yearround ambient air temperature was linearly associated with KD cases. Furthermore,
linear association was only noted for the dry season, but not for the wet season.

(484 words)*The abstract, containing background, objectives, methods, results and conclusion should not exceed 300500words and printed double sided on A4 paper).