Guillain–Barré syndrome in low-income and middle-income countries: challenges and prospects

Papri, Nowshin; Islam, Zhahirul; Leonhard, Sonja E.; Mohammad, Quazi Deen; Endtz, Hubert P.; Jacobs, Bart C.

doi:10.1038/s41582-021-00467-y

Cited by 47 publications

(92 citation statements)

References 125 publications

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“…[8][9][10] Nevertheless, it is largely similar to that reported by Papri et al where GBS affected more frequently in those aged 21-35 years in Asia, South America, and sub-Saharan Africa. 12 Mean age in our study is similar to a Malaysian and an Indian study, whereas a Bangladesh study and a Southwest China study had older mean age. [8][9][10] Symptoms of antecedent infection were noted in 62.77%, more or less comparable to other studies such as the Malaysian and Indian studies, although the Bangladesh and Southwest China studies had reported less.…”

Section: Discussionsupporting

confidence: 83%

“…[8][9][10][11] Similar to the other studies, more males were affected. [8][9][10][11][12] The peak age groups of 12-19 and 20-29 years (Figure 1) is slightly skewed because YGH does not treat pediatric patients less than 12 years. [8][9][10] Nevertheless, it is largely similar to that reported by Papri et al where GBS affected more frequently in those aged 21-35 years in Asia, South America, and sub-Saharan Africa.…”

Section: Discussionmentioning

confidence: 99%

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Guillain‐Barré syndrome (GBS) in a tertiary general hospital at Yangon, Myanmar

Ohnmar

Hlaing

Win

et al. 2022

Neurology & Clinical Neurosc

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Aim:The aim of the study was to study the profile of Guillain-Barré syndrome (GBS) patients admitted at Yangon General Hospital (YGH), Myanmar. Methods:Patients with flaccid quadriparesis due to GBS admitted to the Department of Neurology, YGH in 2019 were prospectively studied.Results: Ninety-four GBS patients were recruited. Mean age was 36.2 years. Male to female ratio was 2.4:1. Patients were admitted 12.1 ± 14.8 days after disease onset. 46.8% were from outside the Yangon region. Peak incidence was in rainy season (47.9%). 62.8% reported symptoms suggestive of preceding infection: 45.7% unspecified fever, 3.2% upper respiratory infection, 8.5% diarrhea, and 5.3% fever with rash. 27.7% had bulbar and 44.7% had facial weakness. 5.3% had GBS/Miller Fisher syndrome overlap. Electrophysiologically, 50% were acute inflammatory demyelinating polyneuropathy (AIDP), 30% acute motor axonal neuropathy (AMAN), and 20% acute motor-sensory axonal neuropathy (AMSAN). Maximum disability was reached at 5.6 ± 4.78 days from onset. The plateau phase lasted 12.12 ± 14.27 days.13.8% required ventilator support. 64.9% of patients received limited manual plasma exchange, 9.6% standard plasma exchange, 4.3% intravenous immunoglobulin and 21.3% no specific treatment. 79.8% had good clinical recovery at 4 weeks from inclusion. Mortality was 0%. Severity at admission was identified as the only poor recovery predictor. Conclusion:Guillain-Barré syndrome in a Yangon tertiary hospital peaked in rainy season and axonal GBS accounted for 50% cases. However, diarrhea was an uncommon antecedent. The good recovery was noted in 79.8% and largely predicted by severity of disease at admission.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Guillain‐Barré syndrome (GBS) in a tertiary general hospital at Yangon, Myanmar

Ohnmar

Hlaing

Win

et al. 2022

Neurology & Clinical Neurosc

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“…30,32 However, plasmapheresis is less expensive than IVIG and could theoretically be the preferred treatment option in low-income countries. 34,35,36 The lack of national treatment guidelines and the high costs of existing treatment contribute to poorer prognostic outcomes and higher GBS mortality rates in low-income countries compared to high-income countries. 37 Cytoalbumin dissociation is one of the validated diagnostic criteria for GBS, reflecting impaired blood-CSF barrier due to neuroinflammation.…”

Section: Discussionmentioning

confidence: 99%

Profile Of Children With Guillan Barre Syndrome In RSUP Haji Adam Malik Medan: Events In 5 Years

H¹,

Dimyati²,

Hasibuan³

2021

IJRP

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Background : Guillain-Barré syndrome (GBS) is an acute demyelinating disease of the peripheral nervous system characterized clinically by flaccid paralysis. The mortality rate in children is about 3-5%. Early diagnosis and therapy important for patient's prognosis. Objective : The aim of this study was to acquaint the profile of children with Guillain-Barré syndrome at the RSUP HAM Medan Hospital from 2016 to 2020. Methods : This study is a descriptive study with a retrospective design. The population and sample with total sampling of the children with GBS diagnosed at the HAM Medan Hospital recorded in the medical record from January 2016 to December 2020. The data were analyzed univariately and presented with a frequency distribution. Results: From this study, 41 children with GBS were found. There were 18 children (43.9%) with age between 10-14 year (female was 22 people (53.7%). Based on the Brighton Criteria for GBS children, most of the children was on level 2 that were 35 people (85 ,4%). From the results of the EMG (Electromyography) examination in GBS children, 24 people (58.5%). had the most types of GBS were Acute Motor Axonal Neuropathy (AMAN). There was no cytoalbumin dissociation was found on CSF analysis. Mostly 28 people had supportive therapy, that was the most used type of therapy. The disability scale shows that children who can walk with the help of a cane or supporting equipment (disability scale 3) was 26 people (63.4%). Based on the length of stay in the hospital, 26 children (63.4%) were treated for 8-14 days. Conclusion: Majority the case of GBS in the RSUP HAM Medan was similar previous studies. Our results can be used as baseline data for understanding the characteristics of GBS in Indonesia.

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“…made based upon clinical features and confirmed by nerve conduction studies (NCSs) which can differentiate subtypes such as demyelinating and axonal (Papri et al, 2021;Willison et al, 2016). NCSs are the most informative test to confirm the diagnosis and detect abnormalities in an early stage of the disease within two weeks (Burns, 2008;Hadden et al, 1998).…”

Section: Open Access | Research Notes Issn: 2576-828xmentioning

confidence: 99%

Electrophysiological features of Guillain-Barré syndrome in Mongolian adult patients

Gantumur

Rentsenbat²,

Jambal³

et al. 2021

Neurosci Res Notes

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The Guillain-Barré syndrome (GBS) is a rare but severe disorder that affects peripheral nerves and is classified into several subtypes based on clinical presentation and electrophysiological abnormalities. Incidence and predominant subtypes of GBS differ geographically. The diagnosis is made upon clinical features and confirmed by nerve conduction studies (NCSs) which can differentiate subtypes such as demyelinated and axonal. Demyelinating subtypes in Europe and North America and axonal subtypes in Asia are predominant. Electrophysiological subtypes have not been determined in Mongolia. Therefore, we aimed to determine common electrophysiological subtypes of Guillain-Barré syndrome in Mongolia. In our study, 75 patients referred to Reflex Neurological Clinic between 2016 and 2019 were retrospectively reviewed. After excluding the cases by the criteria, patients were classified as demyelinating, axonal, normal and equivocal subtypes based on Hadden criteria. We compared the electrophysiological features of axonal and demyelinating subtypes. SPSS-23 was used for statistical analysis. The results are expressed in averages (standard deviations) and percentages (numbers). The difference between the mean and the group of variables was calculated using the T-test and the Chi-square test. Patients were 44% male (33), and the mean age was 46.4±15.1. There was no significant association between seasonal factors and electrophysiological subtypes. Among 75 patients with Guillain-Barré syndrome, a nerve conduction study was performed in the first week on 36% of patients, 33.3% in the 2nd week, and others in the 3rd-4th week after symptom onset. Electrophysiology subtypes were classified as demyelinating (65.3%), axonal (20%), within the normal range (5.4%) and equivocal (9.3%) based on Hadden criteria. The absence of F-waves on electrophysiological examination was higher in patients within 14 days of the disease onset, whereas non-sensory changes were higher in patients after 14 days. We conclude that acute inflammatory demyelinating neuropathy (AIDP) was the most frequent subtype of GBS in Mongolia.

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Guillain–Barré syndrome in low-income and middle-income countries: challenges and prospects

Cited by 47 publications

References 125 publications

Guillain‐Barré syndrome (GBS) in a tertiary general hospital at Yangon, Myanmar

Guillain‐Barré syndrome (GBS) in a tertiary general hospital at Yangon, Myanmar

Profile Of Children With Guillan Barre Syndrome In RSUP Haji Adam Malik Medan: Events In 5 Years

Electrophysiological features of Guillain-Barré syndrome in Mongolian adult patients

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