Epidemiology of Guillain–Barré Syndrome in Aruba

Suryapranata, Franciska S. T.; Ang, C. Wim; Chong, Luis; Murk, Jean Luc; Falconi, Jaime; Huits, Ralph

doi:10.4269/ajtmh.15-0070

“…In studies of children 15 years of age and younger, the highest male-to-female ratio was documented in El Salvador (1.8:1) [35] and the lowest in Brazil (1.2:1) [41] and Honduras 1.3:1 [37]. Among all ages, the highest male-to-female ratio was documented in Aruba (2.3:1) [46], followed by Argentina (1.6:1) [40], and the lowest in Brazil (1.3:1) [42].…”

Section: Resultsmentioning

confidence: 99%

“…The association of DENV infection with GBS is not well established. One multi-year study in Aruba found a positive correlation between number of GBS cases and laboratory-confirmed DENV infections (p = 0.004, Kendall’s tau-b) [46]. However, a study from Brazil reported no association between DENV outbreaks and GBS [64].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean before and during the 2015–2016 Zika virus epidemic: A systematic review and meta-analysis

Capasso

¹

,

Ompad

²

,

Vieira

³

et al. 2019

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Background A severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. Enhanced surveillance of GBS in Latin America and the Caribbean (LAC) following the 2015–2016 Zika virus (ZIKV) epidemic presents an opportunity to estimate, for the first time, the regional incidence of GBS. Methods and findings For this systematic review and meta-analysis, we searched nine scientific databases and grey literature from January 1, 1980 to October 1, 2018. Sources with primary data on incident GBS cases in LAC within a well-defined population and timeframe, published in English, Spanish, Portuguese, or French, were included. We calculated the annual GBS incidence rates (IRs) and 95% confidence intervals (CIs) for each source based on published data. Following an assessment of heterogeneity, we used random-effects meta-analysis to calculate the pooled annual IR of GBS. The study is registered with PROSPERO, number CRD42018086659. Of the 6568 initial citation hits, 31 were eligible for inclusion. Background annual GBS IRs in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29–2.12, I 2 <0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 (95% CI 2.3–2.9) times during ZIKV and 1.9 (95% CI 1.1–3.4) times during chikungunya outbreaks over background rates. A limitation of this review is that the studies included employed different methodologies to find and ascertain cases of GBS, which could contribute to IR heterogeneity. In addition, it is important to consider that data on GBS are lacking for many countries in the region. Conclusions Background IRs of GBS appear to peak during arboviral disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness, particularly during arboviral epidemics. Trial registration Registered with PROSPERO: CRD42018086659 .

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“…We reviewed 135 full-text articles, of which 31 were eligible for inclusion ( Fig 1). Of the 31 studies, 28 reported countryspecific GBS rates from 13 LAC countries (Tables 1 & 2), 3 regional rates, [18,35,36] 15 background rates [18,[35][36][37][38][39][40][41][42][43][44][45][46][47][48], 11 rates during an arboviral outbreak [49][50][51][52][53][54][55][56][57][58][59], and 5 compared rates before and during an outbreak [27,[60][61][62][63]. Many studies presented data from Brazil (29%) and Colombia (16%), and the majority (68%) were published in 2015 or later.…”

Section: Resultsmentioning

confidence: 99%

“…In Veracruz, Mexico, 75% of GBS patients tested positive for C. jejuni infection in 2017 (after the peak of ZIKV) [49]. Studies in Aruba, Brazil, and Colombia-all except the one from Aruba were conducted during the ZIKV epidemic-found no association between C. jejuni infection and GBS [43,46,50,52,55,58]. A study in Brazil found respiratory infections to be present in 27% of GBS patients compared to 7% with gastrointestinal infections in pre-ZIKV years (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002) [43].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean Before and During the 2015-2016 Zika Virus Epidemic: A Systematic Review and Meta-Analysis

Capasso

¹

,

Ompad

²

,

Vieira

³

et al. 2019

View full text Add to dashboard Cite

BackgroundA severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. Enhanced surveillance of GBS in Latin America and the Caribbean (LAC) following the 2015-2016 Zika virus (ZIKV) epidemic presents an opportunity to estimate, for the first time, the regional incidence of GBS. Methods and findingsFor this systematic review and meta-analysis, we searched nine scientific databases and grey literature from January 1, 1980 to October 1, 2018. Sources with primary data on incident GBS cases in LAC within a well-defined population and timeframe, published in English, Spanish, Portuguese, or French, were included. We calculated the annual GBS incidence rates (IRs) and 95% confidence intervals (CIs) for each source based on published data. Following an assessment of heterogeneity, we used random-effects meta-analysis to calculate the pooled annual IR of GBS. The study is registered with PROSPERO, number CRD42018086659. Of the 6568 initial citation hits, 31 were eligible for inclusion. Background annual GBS IRs in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29-2.12, I 2 <0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 (95% CI 2.3-2.9) times during ZIKV and 1.9 (95% CI 1.1-3.4) times during chikungunya outbreaks over background rates. ConclusionsBackground IRs of GBS appear to peak during arboviral disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness, particularly during arboviral epidemics. Trial registrationRegistered with PROSPERO: CRD42018086659. Author summaryA severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. This is the first systematic review on GBS incidence in Latin America and the Caribbean before and during arboviral disease outbreaks. There is a large subregional and annual fluctuation in the incidence of GBS. Background annual GBS incidence rates (IRs) in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29-2.12, I 2 <0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 times during ZIKV and 1.9 times during chikungunya outbreaks over background rates. GBS is a costly disease, which can result in long-term disability and high mortality rates in resource constrained healthcare settings. Because GBS can be triggered by arboviral infections, baseline incidence of GBS is critical for detecting neglected tropical disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness.Incidence of Guillain-Barré Syndrome in LAC and arboviral disease outbreaks PLOS Neglected Tropic...

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“…The occurrence of ADEM and myelitis in Dengue are rare (6)(7)(8)(9). Guillain Barre syndrome (GBS) has been more commonly linked to dengue infection in a number of cases series associated with hypokalemic paralysis but also with demyelination (10,11). The neurologic syndromes associated with Dengue have also been reported in a case series from Jamaica (12); GBS was diagnosed in 3.7% but there were no cases of acute myelitis.…”

Section: Discussionmentioning

confidence: 99%

Acute Paralysis and Neuro-inflammation in Jamaican Children during ZIKV and Dengue Epidemics of 2016

Melbourne-Chambers¹,

Christie²,

Greenaway³

et al. 2016

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Dengue, Chikungunya virus (CHIKV) and Zika virus (ZIKV) are all transmitted by the Aedes aegypti mosquito and are currently circulating in Jamaica. Jamaica has been experiencing a ZIKV epidemic since February 2016. At the University Hospital of the West Indies (UHWI), Kingston, Jamaica, a cluster of five cases of paralysis attributed to neuro-inflammation was noted amongst adolescents admitted to the institution. Three were diagnosed with acute myelitis and one each with acute disseminated encephalomyelitis (ADEM) and Guillain Barre syndrome (GBS). In these patients, there were common presenting symptoms, characteristic findings of peripheral nerve involvement and a history of contact with persons with symptoms of possible ZIKV in the majority. In only one case was a viral association, Dengue infection, confirmed. This case series suggests a unique clinical pattern of neuro-inflammation in Jamaican adolescents occurring during the ZIKV epidemic and questions the role of the three circulating arboviruses in the pathogenesis.

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Epidemiology of Guillain–Barré Syndrome in Aruba

Cited by 15 publications

References 27 publications

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean before and during the 2015–2016 Zika virus epidemic: A systematic review and meta-analysis

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean before and during the 2015–2016 Zika virus epidemic: A systematic review and meta-analysis

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean Before and During the 2015-2016 Zika Virus Epidemic: A Systematic Review and Meta-Analysis

Acute Paralysis and Neuro-inflammation in Jamaican Children during ZIKV and Dengue Epidemics of 2016

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