Apetse K, Dongmo Tajeuna J J, Kumako V K, Waklatsi K P, Kombate D, Assogba K, Balogou A K
Faculté des sciences de la santé, Université de Lomé, Lomé, Togo.
Service de neurologie, CHU CAMPUS de Lomé, Lomé, Togo.
Med Trop Sante Int. 2021 Sep 4;1(3). doi: 10.48327/mtsibulletin.2021.124. eCollection 2021 Sep 30.
In sub-Saharan Africa characterized by limited resources especially in health facilities and a relatively higher frequency of infectious diseases, studies on Guillain-Barré syndrome (GBS) are rare.
The objectives of this work are to describe the characteristics of GBS in Togo through a cohort of patients followed in the neurology unit of the Campus University Hospital of Lomé.
The study took place from May 2015 to July 2019. Patients with GBS of levels 1 to 3 of the Brighton criteria for diagnostic certainty were included consecutively and assessed at admission, at 6 months and at 1 year with the GBS disability score and the MRC sum score. Qualitative and quantitative variables were expressed, respectively, in frequency and median (interquartile range).
Out of 7012 hospitalized patients, 28 (0.39%) including 20 women (71%) with a median age of 40 (27-53) years, presented GBS. The clinical presentation mainly consisted of bilateral sensory-motor disorders predominantly in the lower limbs associated with facial diplegia and preceded by an infectious event. On admission, 39% of patients (n=11) were able to walk (GBS score 0 to 3) and the median MRC sum score was 28 (12-38). Cytoalbuminologic dissociation was present in 654% of patients (13 of 20 patients who underwent lumbar puncture). The demyelinating and axonal subtypes each accounted for 47% (9 of 19 patients who underwent an electroneuromyography examination). Immunoglobulins and intravenous corticosteroid therapy were administered in 18% (n=5) and 50% (n=14) of patients, respectively. Lethality rate during hospitalization was 11% (n=3). The median MRC sum score at 6 and 12 month-outcome were 40 (38-49) and 51 (46-58), respectively. After one year of evolution, case fatality rate was 18% (n=5), and 78% of survivors (n=14) could walk without assistance, of which 17% (n=3) were asymptomatic.
In Togo, GBS, with a low hospital prevalence, remains a serious condition due to its high morbidity and lethality related to non-optimal treatment and delayed management.
在资源有限尤其是卫生设施匮乏且传染病发病率相对较高的撒哈拉以南非洲地区，关于吉兰 - 巴雷综合征（GBS）的研究很少。
本研究的目的是通过在洛美大学医院校区神经内科随访的一组患者来描述多哥GBS的特征。
研究于2015年5月至2019年7月进行。连续纳入符合布莱顿诊断确定性标准1至3级的GBS患者，并在入院时、6个月和1年时用GBS残疾评分和医学研究委员会（MRC）总分进行评估。定性和定量变量分别以频率和中位数（四分位间距）表示。
在7012名住院患者中，28例（0.39%）患有GBS，其中包括20名女性（71%），中位年龄为40岁（27 - 53岁）。临床表现主要为双侧感觉运动障碍，以下肢为主，伴有面瘫，且发病前有感染事件。入院时，39%的患者（n = 11）能够行走（GBS评分0至3），MRC总分中位数为28（12 - 38）。65.4%的患者（20例接受腰椎穿刺的患者中有13例）存在蛋白细胞分离现象。脱髓鞘和轴索性亚型各占47%（19例接受神经电生理检查的患者中有9例）。分别有18%（n = 5）和50%（n = 14）的患者接受了免疫球蛋白和静脉注射皮质类固醇治疗。住院期间死亡率为11%（n = 3）。6个月和12个月时MRC总分中位数分别为40（38 - 49）和51（46 - 58）。病程一年后，病死率为18%（n = 5），78%的幸存者（n = 14）能够独立行走，其中17%（n = 3）无症状。
在多哥，GBS在医院中的患病率较低，但由于其高发病率和与治疗不优化及管理延迟相关的高致死率，仍然是一种严重的疾病。
