Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome
Mulugeta Sitot Shibeshi,1 Adane Alto Mengesha,2 Kefyalew Taye Gari1 1Department of Pediatrics and Child Health, Hawassa University, Hawassa, Ethiopia; 2Department of Pediatrics and Child Health, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Mulugeta Sitot Shibeshi, Email mulugetasitot@g...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-03-01
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| Series: | Pediatric Health, Medicine and Therapeutics |
| Subjects: | |
| Online Access: | https://www.dovepress.com/pediatric-guillainbarr-syndrome-in-a-resource-limited-setting-clinical-peer-reviewed-fulltext-article-PHMT |
| _version_ | 1797861347249094656 |
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| author | Shibeshi MS Mengesha AA Gari KT |
| author_facet | Shibeshi MS Mengesha AA Gari KT |
| author_sort | Shibeshi MS |
| collection | DOAJ |
| description | Mulugeta Sitot Shibeshi,1 Adane Alto Mengesha,2 Kefyalew Taye Gari1 1Department of Pediatrics and Child Health, Hawassa University, Hawassa, Ethiopia; 2Department of Pediatrics and Child Health, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Mulugeta Sitot Shibeshi, Email mulugetasitot@gmail.comBackground: Guillain–Barré syndrome (GBS) is an acute immune-mediated peripheral neuropathy with a highly variable clinical course and outcome. There remain diagnostic and treatment challenges in resource limited settings. This study aimed to describe the clinical presentation, diagnostic and management challenges, and hospital outcome of children with GBS in southern Ethiopia.Methods: A retrospective chart review of children aged ≤ 14 years who were admitted with a diagnosis of GBS to Hawassa University Comprehensive Specialized Hospital from 2017 to 2021 was done. Medical records of 102 children who fulfilled the Brighton Criteria for GBS were reviewed, and data on demographic, clinical characteristics, investigation findings, treatment, and outcome were collected. Logistic regression analysis was done to determine factors associated with mortality.Results: The mean age of the study subjects was 7.25± 3.91 years and 63.7% were male. Antecedent event was present in 48% of the cases, and the most common triggering factor was upper respiratory tract infection (63.8%). The mean Hughes disability score was 4.23± 0.54, 4.48± 0.71, and 4.03± 0.86 at admission, nadir and discharge from hospital, respectively. Cranial nerve involvement was present in 27.5% of patients and bulbar palsy was the most common finding. Dysautonomia was observed in 57.8% of the participants. Sixty-three patients (61.8%) needed ICU care but only 43 of them (68.3%) were admitted to ICU. Similarly, 31 patients (30.4%) required respiratory support but only 24 of them (77.4%) were on mechanical ventilator. No patient had nerve conduction study. Only 5.9% of patients received IVIG. Thirteen patients (12.7%) died of GBS and the presence of respiratory failure was the only determinant of mortality [AOR = 11.40 (95% CI: 1.818, 71.52), p = 0.009].Conclusion: There is a gap in the diagnosis and management of children with GBS; and mortality from the disease is higher than reports from other settings.Keywords: Guillain–Barre syndrome, outcome, resource limited setting |
| first_indexed | 2024-04-09T22:00:45Z |
| format | Article |
| id | doaj.art-50d6f2eb546e4aab8829303cb9cda262 |
| institution | Directory Open Access Journal |
| issn | 1179-9927 |
| language | English |
| last_indexed | 2024-04-09T22:00:45Z |
| publishDate | 2023-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Pediatric Health, Medicine and Therapeutics |
| spelling | doaj.art-50d6f2eb546e4aab8829303cb9cda2622023-03-23T18:06:53ZengDove Medical PressPediatric Health, Medicine and Therapeutics1179-99272023-03-01Volume 1410711582470Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital OutcomeShibeshi MSMengesha AAGari KTMulugeta Sitot Shibeshi,1 Adane Alto Mengesha,2 Kefyalew Taye Gari1 1Department of Pediatrics and Child Health, Hawassa University, Hawassa, Ethiopia; 2Department of Pediatrics and Child Health, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Mulugeta Sitot Shibeshi, Email mulugetasitot@gmail.comBackground: Guillain–Barré syndrome (GBS) is an acute immune-mediated peripheral neuropathy with a highly variable clinical course and outcome. There remain diagnostic and treatment challenges in resource limited settings. This study aimed to describe the clinical presentation, diagnostic and management challenges, and hospital outcome of children with GBS in southern Ethiopia.Methods: A retrospective chart review of children aged ≤ 14 years who were admitted with a diagnosis of GBS to Hawassa University Comprehensive Specialized Hospital from 2017 to 2021 was done. Medical records of 102 children who fulfilled the Brighton Criteria for GBS were reviewed, and data on demographic, clinical characteristics, investigation findings, treatment, and outcome were collected. Logistic regression analysis was done to determine factors associated with mortality.Results: The mean age of the study subjects was 7.25± 3.91 years and 63.7% were male. Antecedent event was present in 48% of the cases, and the most common triggering factor was upper respiratory tract infection (63.8%). The mean Hughes disability score was 4.23± 0.54, 4.48± 0.71, and 4.03± 0.86 at admission, nadir and discharge from hospital, respectively. Cranial nerve involvement was present in 27.5% of patients and bulbar palsy was the most common finding. Dysautonomia was observed in 57.8% of the participants. Sixty-three patients (61.8%) needed ICU care but only 43 of them (68.3%) were admitted to ICU. Similarly, 31 patients (30.4%) required respiratory support but only 24 of them (77.4%) were on mechanical ventilator. No patient had nerve conduction study. Only 5.9% of patients received IVIG. Thirteen patients (12.7%) died of GBS and the presence of respiratory failure was the only determinant of mortality [AOR = 11.40 (95% CI: 1.818, 71.52), p = 0.009].Conclusion: There is a gap in the diagnosis and management of children with GBS; and mortality from the disease is higher than reports from other settings.Keywords: Guillain–Barre syndrome, outcome, resource limited settinghttps://www.dovepress.com/pediatric-guillainbarr-syndrome-in-a-resource-limited-setting-clinical-peer-reviewed-fulltext-article-PHMTguillain-barre syndromeoutcomeresource limited setting |
| spellingShingle | Shibeshi MS Mengesha AA Gari KT Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome Pediatric Health, Medicine and Therapeutics guillain-barre syndrome outcome resource limited setting |
| title | Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome |
| title_full | Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome |
| title_fullStr | Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome |
| title_full_unstemmed | Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome |
| title_short | Pediatric Guillain–Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome |
| title_sort | pediatric guillain ndash barr eacute syndrome in a resource limited setting clinical features diagnostic and management challenges and hospital outcome |
| topic | guillain-barre syndrome outcome resource limited setting |
| url | https://www.dovepress.com/pediatric-guillainbarr-syndrome-in-a-resource-limited-setting-clinical-peer-reviewed-fulltext-article-PHMT |
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