Acute Flaccid Paralysis: A Registry-based Study of Demographic, Clinical, and Diagnostic Characteristics of Children in a Referral Center in Iran (original) (raw)
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Epidemiology of Acute Flaccid Paralysis in Hormozgan Province, Iran
Disease and Diagnosis
Background: Acute flaccid paralysis (AFP) is a syndrome that occurs with the sudden onset of paralysis in any part of the body of infants and children under 15 years old. This study investigated the epidemiology and causes of AFP in patients under 15 years of age admitted to hospitals in Hormozgan province during 2011-2018. Materials and Methods: After receiving the code of ethics, the information of the studied patients was collected by referring to the health center of Hormozgan province and reviewing their records. The corresponding data were gathered using a checklist that included the causes of paralysis, age, gender, place of residence, and involved organs and then analyzed with SPSS software. Results: Out of 121 patients, 58.7% were males. In addition, 69.4% and 21.5% of these patients were in the age groups of 0-5 and 5-10 years, and the remaining cases were in the age group of 10-15 years. In terms of accommodation, 19.8% and 14.9% of patients lived in Bandar Abbas and Mina...
Iranian journal of pediatrics, 2014
The surveillance of acute flaccid paralysis (AFP) is a key strategy for monitoring the progress of poliomyelitis eradication and is a sensitive measure for detecting potential cases of poliomyelitis and poliovirus infection. This study was conducted to describe the characteristics of patients reported with AFP, and to evaluate the performance of the surveillance system in Kurdistan province, western Iran, using indicators recommended by the World Health Organization (WHO). This observational study was conducted from January 2000 to December 2010 at the Kurdistan Center for Disease Control and the Department of Pediatrics. All children who fulfilled the WHO definition for AFP were included in our study. The stool samples of all the children were sent for poliovirus isolation. All the patients were evaluated for 60 days after the onset of symptoms to identify the signs of residual weakness. One-hundred thirty nine children aged <15 years were reported to the Center for Diseases Con...
Etiology and Clinical Features of Acute Flaccid Paralysis among Children in Gadarif
biomedical-research-and-clinical-reviews, 2020
Acute Flaccid Paralysis (AFP) is a rare but a serious neurological condition characterized by sudden weakness or paralysis of one or more extremities, the respiratory or bulbar muscles and reduced muscle tone without other obvious cause. Death occurs in about 7.5% of AFP affected patients worldwide. AFP is the most common sign of acute polio. Therefore, AFP studies are important for surveillance during polio outbreaks to differentiate polio cases from AFP cases. There is a lack of information about the clinical features & causative factors of AFP among children in Gadarif, Sudan. The identification of AFP cases and its causative factors are important in the management & prevention of the disease. This study assessed the etiology and the clinical features of AFP among children in Gadarif, Sudan aiming at effective management & prevention of the disease. It was a prospective cross sectional study conducted at Gadarif Pediatrics Teaching Hospital during the period of January 2017-Decem...
Clinical profile of acute flaccid paralysis
PubMed, 2002
This study was done to determine the clinical course, cause and outcome of Acute Flaccid Paralysis (AFP) in children. All AFP cases (< 15 years) in the children's ward of Khulna Medical College Hospital (Bangladesh) were recorded, investigated and followed up to sixty days as a part of passive surveillance. Main outcome variables were vulnerable age group, vaccine status, predominant limb involvement, clinical variants, virus isolation and residual paralysis. Thirty-four children with AFP were admitted in hospital in the last three years with the highest number (14) in 1998. The majority of children belonged to the age group 5-9 years with a male female ratio of 1.3:1. Nearly one third of the cases were either partially vaccinated or not vaccinated at all. The lower limbs bore the brunt of paralysis excepting a few (14.7%). Clinically, Guillain Barre Syndrome was the commonest (47.1%) followed by encephalomyelitis. No poliovirus was isolated from these cases. Residual paralysis was observed in four out of ten cases who returned for follow up. AFP will continue to occur even after eradication of poliomyelitis and Guillain Barre Syndrome is the most important clinical entity for this.
Uncommon Disorders Masquerading as Acute Flaccid Paralysis in Children
The Indian Journal of Pediatrics, 2016
The syndrome of acute flaccid paralysis (AFP) is a common medical emergency in children. In the era of poliomyelitis eradication, the common causes of AFP include Guillain-Barré syndrome (GBS), transverse myelitis and traumatic neuritis. However, many common diseases can uncommonly present as AFP and some uncommon diseases may also masquerade like it. Uncommon causes of AFP seen at a tertiary care pediatric hospital are discussed along with relevant points in diagnosis and management. Also, common pitfalls in diagnosis of pediatric AFP and an approach to investigations are discussed.
Evaluation of Acute Flaccid Paralysis in Hamadan, Iran from 2002 to 2009
Epidemiology and Health, 2011
OBJECTIVES: To achieve a polio-free certification in Iran, a nationwide active surveillance program for acute flaccid paralysis (AFP) was set up following World Health Organization guidelines. This article describes the results of an eight-year surveillance of AFP in Hamadan, in the west of Iran. METHODS: A standard set of minimum core variables were collected. All cases of non-polio AFP in children aged < 15 years old were reported. Two stool specimens were collected within 14 days of the onset of paralysis. RESULTS: During the eight-year survey, 88 AFP cases aged < 15 years old were reported. About 40% (35/88) of cases were aged ≤ 5 years, 56% (49/88) were boys, 19 (21.6%) had fever at the onset of paralysis, 74 (84.0%) had complete paralysis within four days of onset, and 22 (24.7%) had asymmetric paralysis. More than one AFP case was detected per 100,000 children aged < 15 years old in all years. The risk of AFP in patients aged < 5 years old was almost double that of older patients. Guillain-Barré Syndrome was the major leading cause of AFP (66/88). Adequate stool specimens were collected from 85% of AFP patients. All stool specimens were tested virologically, but no wild polioviruses were detected. CONCLUSION: The active surveillance of non-polio AFP was efficient over the last eight years and exceeded 1.0 case per 100,000 children aged < 15 years old. Nonetheless, there was a decreasing trend in the detection of AFP cases during the last two years and should be the focus of the policymakers' special attention, although AFP cases were still above the target level.
Acute generalized weakness in patients referred to Amirkola Children’s Hospital from 2005 to 2010
Caspian Journal of Internal Medicine, 2012
Background: Diseases that cause acute flaccid paralysis (AFP) often progress rapidly, thus may cause life threatening complications, therefore, their diagnosis and cure are important. This study was carried out to investigate the causes of acute generalized weakness in children referred to Amirkola Children's Hospital, in Babol, Iran. Methods: In this case series, the epidemiological causes of the disease and clinical features of 15 cases with acute generalized weakness from April 2005 to September 2010 were evaluated. The data were collected and analyzed. Results: The mean age of cases was 4.7±3.5 years. The male/female ratio was 2. Twelve cases had Guillain-Barre syndrome, two with myositis and one with periodic hyperkalemic paralysis. Conclusion: Guillain-Barre syndrome is the most common cause of AFP in children admitted due to acute generalized weakness in Amirkola Children's Hospital.
An Analytical Study of Acute Flaccid Paralysis in a Tertiary Care Centre
2015
Objective: To analyze the incidence, etiology, clinical features, management and short term outcome of Acute Flaccid Paralysis. Design: Prospective observational cross sectional descriptive study. Setting: All the patients diagnosed as Acute Flaccid Paralysis admitted in pediatric wards and ICU of Institute for Women and Child Health, Niloufer Hospital, Osmania Medical College, Hyderabad were taken for the study for a period of 1 year (from Jan 2011 to Dec 2011). Participants: Over a period of 12 months, 32casesof Acute Flaccid Paralysis from the age of 6 months to12years who were admitted in pediatric wards and ICU were included in the study. Those who suffered with diarrhea and improved with electrolyte correction were excluded from the study. Methods: Clinical data was collected with the prescribed proforma. All cases with acute illness with Flaccidness were taken. ENMG, CSF analysis and 2 stool sample analysis were done for all AFP cases. Results: In this study of 32 AFP cases, ...
Etiology and Clinical Features of Acute Flaccid Paralysis among Children in Gadarif, Sudan
Biomedical Research and Clinical Reviews
Acute Flaccid Paralysis (AFP) is a rare but a serious neurological condition characterized by sudden weakness or paralysis of one or more extremities, the respiratory or bulbar muscles and reduced muscle tone without other obvious cause. Death occurs in about 7.5% of AFP affected patients worldwide. AFP is the most common sign of acute polio. Therefore, AFP studies are important for surveillance during polio outbreaks to differentiate polio cases from AFP cases. There is a lack of information about the clinical features & causative factors of AFP among children in Gadarif, Sudan. The identification of AFP cases and its causative factors are important in the management & prevention of the disease. This study assessed the etiology and the clinical features of AFP among children in Gadarif, Sudan aiming at effective management & prevention of the disease. It was a prospective cross sectional study conducted at Gadarif Pediatrics Teaching Hospital during the period of January 2017-Decem...
Journal of Paediatrics and Child Health, 2017
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 longterm 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.