Incidence of Guillain-Barr Syndrome (GBS) in Latin America and the Caribbean before and during the 2015 2016 Zika virus epidemic A systematic review and meta-analysis

摘要

A severe neurological disorder, Guillain-Barr syndrome (GBS) is the leading cause of acute flaccid paralysis. This is the first systematic review on GBS incidence in Latin America and the Caribbean before and during arboviral disease outbreaks. There is a large sub-regional and annual fluctuation in the incidence of GBS. Background annual GBS incidence rates (IRs) in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29 2.12, I2<0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 times during ZIKV and 1.9 times during chikungunya outbreaks over background rates. GBS is a costly disease, which can result in long-term disability and high mortality rates in resource constrained healthcare settings. Because GBS can be triggered by arboviral infections, baseline incidence of GBS is critical for detecting neglected tropical disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness.