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Acute flaccid paralysis in South African children: Causes, respiratory complications and neurological outcome
Author(s) -
van der Pijl Jolanda,
Wilmshurst Jo M,
van Dijk Monique,
Argent Andrew,
Booth Jane,
Zampoli Marco
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13709
Subject(s) - medicine , mechanical ventilation , guillain barre syndrome , acute flaccid paralysis , flaccid paralysis , paralysis , logistic regression , pediatrics , retrospective cohort study , presentation (obstetrics) , anesthesia , surgery , poliovirus , virus , virology
Aim To describe the causes, clinical presentation and neurological outcome of acute flaccid paralysis in children. Methods A retrospective study in a tertiary paediatric hospital in South Africa. Data on clinical presentation, respiratory complications and long‐term neurological outcomes of children presenting with acute flaccid paralysis were collected. Logistic regression analysis was applied to determine predictors for the need of mechanical ventilation. Results The study included 119 patients, 99 of whom had Guillain‐Barré syndrome (GBS); 47 patients (39.5%) required mechanical ventilation. Backward logistic regression analysis revealed that bulbar dysfunction ( P < 0.001), autonomic dysfunction ( P = 0.003) and upper limb paralysis ( P = 0.038) significantly predicted the need for mechanical ventilation. EuroQol‐5D scores of self‐care problems and usual activities after discharge significantly declined over time. Conclusions In this large series from Africa, GBS was the main cause of acute flaccid paralysis in children and was associated with significant morbidity. Other causes of acute flaccid paralysis mimicking GBS were not uncommon and should be excluded in this setting.