Epidemiological trends and healthcare burden of Kawasaki disease in children under 5 years in Taiwan

Kawasaki disease (KD) is a systemic pediatric vasculitis with a globally increasing incidence; however, its epidemiological trends in Taiwan remain inadequately characterized. This study aimed to examine the incidence and healthcare demands associated with KD, particularly refractory KD, among children under 5 years of age in Taiwan. A retrospective analysis of the National Health Insurance Research Database was conducted, identifying patients based on International Classification of Diseases codes and intravenous immunoglobulin (IVIG) treatment records from 2009 to 2020. Demographic and clinical characteristics were analyzed, and comparisons were made between refractory and non-refractory KD groups. The incidence of KD increased from 56.13 to 88.76 per 100,000 person-years during the study period, with higher rates observed among males and children younger than 2 years. Seasonal peaks occurred during warmer months, and a higher burden was noted in urbanized northern regions. Refractory KD accounted for 14.2% of cases and was associated with greater healthcare utilization, including additional IVIG courses, longer hospitalization; anticoagulant use (1.34% vs. 0.38%) and coronary angiography (1.26% vs. 0.49%) were higher but infrequent. These findings highlight the rising incidence and medical burden of KD in Taiwan, underscoring the importance of continued surveillance and optimized management strategies for affected children.