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Childhood Guillain-Barré syndrome in Paraguay, 1990 to 1991

D E Hart1, L A Rojas, J A Rosário

  • 1Neuroepidemiology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

Annals of Neurology
|December 1, 1994
PubMed

Insights

This study found that Guillain-Barré syndrome in Paraguayan children had a lower hospitalization rate but similar overall severity compared to other pediatric cases. Organophosphate pesticide exposure was noted as a potential factor.

Area of Science:

  • Neurology
  • Epidemiology
  • Pediatrics

Background:

  • Guillain-Barré syndrome (GBS) is a rare neurological disorder.
  • Understanding pediatric GBS incidence and clinical course is crucial for public health.
  • Paraguay's national surveillance program provided data on acute flaccid paralysis.

Purpose of the Study:

  • To determine the incidence and clinical characteristics of Guillain-Barré syndrome in children in Paraguay.
  • To investigate potential risk factors, including pesticide exposure and seasonality, for pediatric GBS.
  • To compare the Paraguayan pediatric GBS cohort with international data.

Main Methods:

  • Analysis of data from a national surveillance program for poliomyelitis (1990-1991).
  • Identification of children (<15 years) with incident acute flaccid paralysis.
  • Diagnosis of Guillain-Barré syndrome based on established criteria.
  • Assessment of clinical course, including hospitalization, respiratory compromise, and outcomes.

Main Results:

  • 37 out of 50 reported cases of acute flaccid paralysis were diagnosed as Guillain-Barré syndrome.
  • The average annual incidence rate was 1.1 per 100,000 children.
  • Clinical course showed lower hospitalization (57%), respiratory compromise (8%), and intubation (5%) rates compared to other series.
  • A 3% case-fatality rate and 81% total recovery at 12 months were observed.
  • Peak symptom onset occurred from January to April, coinciding with warmer months.
  • 30% of patients had potential organophosphate pesticide exposure, with peak pesticide use aligning with GBS incidence.
  • No correlation was found between GBS occurrence and prior immunization.

Conclusions:

  • Pediatric Guillain-Barré syndrome in Paraguay presented with a relatively benign clinical course regarding hospitalization and respiratory complications.
  • Organophosphate pesticide exposure and seasonal factors may play a role in the incidence of pediatric GBS in the region.
  • The findings highlight the importance of regional surveillance and etiological investigations for Guillain-Barré syndrome in pediatric populations.

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