Pattern of incidence in Guillain-Barre syndrome admitted to Teaching Hospital, Galle, Sri Lanka from 1995 to 2000

Abstract

Guillain-Barre syndrome (GBS) is the commonest cause of acute flaccid paralysis in Sri Lanka. Annual incidence of GBS in Sri Lanka is not known. The aim of this study was to find out the incidence of GBS in administrative district of Galle, Sri Lanka based on hospital records. Method: We conducted a retrospective analytical study to find out the incidence and epidemiological patterns of GBS in patients admitted to Teaching Hospital Galle (THG). We scrutinized the case notes of all the patients categorized G 61.0 of 10th Edition of International Classification of Diseases Classification, from 1995 through 2000. The cases fulfilling NINCDS criteria for GBS were included in the study. We excluded the patients referred from other districts for calculation of the incidence of GBS in Galle. Official population statistics and the regional rainfall recorded in the meteorological department were used for analysis. Results: There were 114 patients fulfilling the inclusion criteria over the study period. Seventysix patients were from Galle District and 54% were males. The age distribution showed a bimodal pattern with peak incidence in 10-19 age group and a smaller peak in 30-39 age group. Number of cases from Galle District reported in years 1995 to 2000 was 8, 16, 15, 18, 8 and 11 respectively. This is equivalent to a crude incidence of 0.8, 1.6, 1.5, 1.8, 0.8 and 1.1 per /100,000 population for each year respectively considering the mean population of 1.04 million. Mean crude incidence for the study period was 1.26 per 100000. Seasonal variation with clustering following high rainfall was seen in years 1996, 1997 and 1998. Identified preceding illnesses recorded in the notes were upper respiratory tract infection in 22.7%, diarrhoea in 14%, varicella in 8% and non-specific viral infection in 14%. Conclusion: The mean incidence of GBS in Galle District is 1.26 per 100,000 population with a range of 0.8 to 1.8 over the study period. The age distribution and seasonal variation are different from those reported from many other countries. The clinical features and preceding illness were similar to those described in other series.