Search

Background: Zika produced the highest increase in the incidence of Guillain-Barré syndrome (GBS) in Latin America in the last decade. The Neuroinfections Emerging in the Americas Study (NEAS) was established in 2016 to investigate the association of emerging infectious disorders with GBS in Colombia. The present study assessed the role of preceding infections, including arboviruses and other pathogens, as risk factors for GBS., Methods: A case-control study was conducted prospectively between June 2016 and December 2019 in 5 Colombian cities. We recruited newly diagnosed patients with GBS and a house control plus an age and season-matched-hospital control per case. Clinical information, blood, CSF, and urine samples were used to diagnose bacterial and viral infections. Anti-glycolipid antibodies were identified in serum. Statistical analyses were performed using conditional logistic regression., Findings: Fifty-seven patients with GBS, 66·7% male, 52 years of median age, were recruited along with 77 (55 house and 22 hospital) controls. GBS was associated with presenting diarrhea (adjusted OR 10·94; 95% CI 1·8-66·29; p=0·009) and a history of recent upper respiratory tract infection (aOR 13·91; 95% CI 2·38-81·1 p=0·003). Specific recent infections did not significantly differ between cases and controls, but the number of infections was associated with GBS (aOR=1·77 95% CI 1·04-3·01 p=0·03). C. jejuni (74%), M. pneumoniae (23%), and Chikungunya (7%) were the most frequent infections. Anti-glycolipid IgG against GM1 and their heterodimer complexes were identified to be associated with GBS., Conclusions: After the Zika epidemic, infections causing diarrhea and upper respiratory diseases contributed to the burden of GBS in Colombia. Prevention and control of food-borne pathogens could reduce the incidence of GBS in Colombia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Osorio et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Competing Interests: Conflicts of interest None declared.

Background: Guillain-Barré Syndrome (GBS) can lead to significant functional impairments, yet little is understood about the recovery phase and long-term consequences for patients in low- and medium-income countries., Objective: To evaluate the functional status and identify factors influencing outcomes among patients with GBS in Colombia., Methods: Telephone interviews were conducted with GBS patients enrolled in the Neuroviruses Emerging in the Americas Study between 2016 and 2020. The investigation encompassed access to health services and functional status assessments, utilizing the modified Rankin Scale (mRS), GBS Disability Score (GDS), Barthel Index (BI), and International Classification of Functioning (ICF). Univariate analysis, principal component analysis, linear discriminant analysis, and linear regression were employed to explore factors influencing functional status., Results: Forty-five patients (mean age = 50[±22] years) with a median time from diagnosis of 28 months (IQR = 9-34) were included. Notably, 22% and 16% of patients did not receive rehabilitation services during the acute episode and post-discharge, respectively. Most patients demonstrated independence in basic daily activities (median BI = 100, IQR = 77.5-100), improvement in disability as the median mRS at follow-up was lower than at onset (1 [IQR = 0-3] vs. 4.5 [IQR = 4-5], p < 0.001), and most were able to walk without assistance (median GDS = 2, IQR = 0-2). A shorter period from disease onset to interview was associated with worse mRS (p = 0.015) and ICF (p = 0.019). Negative outcomes on GDS and ICF were linked to low socioeconomic status, ICF to the severity of weakness at onset, and BI to an older age., Conclusions: This study underscores that the functional recovery of GBS patients in Colombia is influenced not only by the natural course of the disease but also by socioeconomic factors, emphasizing the crucial role of social determinants of health., Competing Interests: Conflict of interest Declarations of interest: none., (Copyright © 2024 Elsevier B.V. All rights reserved.)