Acute flaccid paralysis incidence rate and epidemiology in children in Lebanon: a rise in numbers in the post-vaccination and refugee crisis era

Abstract

Background: Acute flaccid paralysis (AFP) is a clinical syndrome characterized by the acute onset of weakness and paralysis with reduced muscle tone. This study explored the incidence and different aspects of AFP in Lebanese children between 2009 and 2019.
 Methods: AFP data were collected from the Lebanese Ministry of Public Health. Incidence rate according to year, age groups, clinical data, follow-up, diagnosis, and vaccination status was analyzed in the 11-years period.
 Results: AFP incidence rates increased importantly from 0.63 per 100,000 in 2009 till 4.96 per 100,000 in 2019. Most of the patients were children under ten years of age, 40.6% of all cases were under five years old, and 37.9% were between 5 and 9 years old. Follow-up revealed that approximately two out of five patients experienced residual weakness. As for the final diagnosis, around 30% of cases were diagnosed as Guillain-Barre Syndrome (GBS). Most cases were children having received between 3 and 5 doses of polio vaccine.
 Conclusions: The rise in cases coincided with the Syrian refugee crisis in Lebanon and the progressively deteriorating economy in the country; yet, incidence rates were in the lower margin compared with other countries.
 Keywords: Acute flaccid paralysis; Epidemiology; Guillain-Barré Syndrome; Lebanon; Pediatrics.

Diagnostic Pitfalls in Guillain–Barré Syndrome: Case Report and Literature Review

“…A retrospective study conducted in Lebanon from 2009–2019 on 631 pediatric patients with acute flaccid paralysis showed that GBS accounted for 32.1% of the cases [ 59 ]. In order to rule out metabolic or electrolyte dysfunctions, as well as infections that can cause acute flaccid paralysis [ 60 ], we performed laboratory testing guided by the differential diagnosis with complete blood counts and studies of glycemia, electrolytes, liver and renal functions.…”

Protocolo de vigilancia en salud pública. Parálisis flácida aguda

“…Sin embargo, el Síndrome de Guillain-Barré (SGB) prevalece como el diagnóstico más común, seguido por la mielitis transversa y las polineuropatías, entre otras condiciones. ; la importancia de la vigilancia de comportamientos inusuales del SBG es esencial para el control y la erradicación global de la poliomielitis (14).…”

Effects of Customized Biomechanical Footwear on Gait and Balance in Individuals with Polio: A Randomized Controlled Trial

“…Etiological factors behind AFP are multiple, including both infections and non-infectious causes 6 . Infections mainly occur due to viruses and bacteria, whereas non-infectious causes may include neurological lesions, trauma, toxic exposure, cancer, and other factors 7 . Evidence suggests that more than 50% of AFP is caused by Guillian-Barree Syndrome (GBS), an autoimmune disease with multiple etiology 8 .…”