epidemiologic features of kawasaki disease in middle east countries: a systematic review and meta-analysis

Background: considering the geography and cultural affinity of middle east countries, pooled data on the epidemiological features of kawasaki disease (kd) in this region remain limited. objectives: this study aims to review the studies on the most important epidemiological characteristics of kd in middle east countries, including age and gender distribution, prevalence of atypical kd and coronary artery lesions (cals), and the seasonal pattern of kd occurrence. methods: this is a systematic review and meta-analysis study conducted according to the preferred reporting items for systematic reviews and meta-analyses (prisma) guideline. by using relevant keywords with boolean operators and utilizing truncation and wildcards, a search was conducted on google scholar, pubmed, and web of science for related studies focusing on 19 countries in the middle east, published until march 2025, excluding case reports and clinical trials, and including population-based or hospital-based studies with acceptable quality, assessed using the strobe checklist. a meta-analysis was performed using stata software, version 17.results: forty-four articles were included for meta-analysis. the pooled estimation of age was 36.88 months (95% ci, 33.54%, 40.22%). the male-to-female sex ratio was 1.7:1, and the prevalence of cal and atypical kd was estimated to be 32% (95% ci, 26%, 38%) and 38% (95% ci, 26%, 50%), respectively. the prevalence of kd in spring, summer, autumn, and winter was 30%, 20%, 19% and 31%, respectively. conclusions: while age, gender, and seasonal distribution of kd are consistent with global statistics, the prevalence of cal in patients and atypical forms of this disease is notably higher in the middle eastern region.