Clinical Profile Of Acute Flaccid Paralysis In A Tertiary Centre In South-South, Nigeria.

Abstract

Background: Surveillance of acute flaccid paralysis (AFP) was an important public health
activity in many countries prior to the eradication of Poliomyelitis. Following the eradication of Polio in Nigeria and globally, it is paramount to identify other major contributors to clinical burden of AFP.
This study was designed to describe the epidemiology, clinical ~ characteristics, and differential diagnosis of causes of AFP over a 10 year period in a tertiary hospital.

Methods: The case notes of patients who were admitted in the Paediatric Neurology unit of the University of Calabar teaching hospital with clinical features suggestive of AFP cases between January 2011 and December 2020 were studied. They were diagnosed on the basis of history and physical examination. The underlying actiology was ascertained by appropriate investigations such as cerebrospinal fluid analysis, electrolytes and imaging.

Results: Acute flaccid paralysis accounted for 0.02% of all admissions into the Neurology unit over the study period. Out of 20 patients with AFP, 7 had acute inflammatory demyelinating polyneuropathy, a subtype of Guillain-Barré syndrome (GBS), Acute disseminated encephalomyelitis 3 (15%), Transverse myelitis 3 (15%), Myasthenia gravis 2 (10%), Meningoencephalitis 1(10%), Traumatic neuritis 3 (15%) and Acute hemiplegia of childhood 2 (10%).
There was no case of Poliomyelitis. The greater proportion of the patients studied were from the 10- 15 age group. There were more females in the study population with a Male to Female ratio of 1:1.2

Conclusion: Non-polio cases were the causes of AFP in Calabar. GBS was the most common cause of AFP followed by traumatic neuritis and ADEM. Paraplegia and fever were common clinical presentations.