Background. Kawasaki disease (KD) is acute systemic vasculitis of childhood and a leading cause of acquired heart disease. Early diagnosis and intravenous immunoglobulin therapy substantially reduce coronary complications and mortality. In Ukraine, KD was not routinely registered in national health databases until 2020, and no national registry exists, limiting reliable epidemiological assessment.
Objectives. To evaluate the epidemiology of KD in Ukraine using a multi-source approach integrating a systematic review of published pediatric KD cases since Ukraine’s independence (1991–2025), analysis of national administrative data for KD and MIS-C to assess diagnostic overlap during the COVID-19 era, and extrapolation of contemporary KD incidence from high-detection single-center experience in Kyiv.
Methods. A systematic search of published clinical reports of pediatric KD in Ukraine (1991–2025) was conducted using PubMed, Google Scholar, Ukrainian medical professional publications. Aggregated National Health Service of Ukraine (NHSU) data available since 2020 were analyzed for KD (ICD-10 M30.3) and multisystem inflammatory syndrome in children (MIS-C; ICD-10 U10.9). The crude annual KD incidence for Kyiv in 2024 was estimated using the number of diagnosed cases and the pediatric population under five.
Results. The literature review identified approximately 50 documented pediatric KD cases over three decades, including two acute-phase fatalities and a single-center series of 23 cases from Kyiv (2016–2017; incidence 4.6). Publication activity increased over time from rare early reports to near-annual and, more recently, multiple publications per year. NHSU data for 2020–H1 2025 captured 588 KD cases and 194 MIS-C cases (fig. 1). Because the MIS-C code entered routine use only from 2022, diagnostic and coding overlap with KD during the COVID-19 period is likely. Marked regional heterogeneity was observed, with higher detection in major referral regions (Fig. 2). In Kyiv, the minimal KD incidence in 2024 reached 11 per 100,000 children under five.
Conclusions. KD in Ukraine has been substantially underdiagnosed for decades. Literature-based and administrative data underestimate the true disease burden. Single-center data from Kyiv suggest that current KD incidence in Ukraine is comparable to other European countries, highlighting the need for a national registry, standardized diagnostic and coding practices, and improved clinician awareness.