Clinical characteristics, temporal patterns, and outcomes of Guillain–Barré syndrome: A 7-year cross-sectional study in a low-resource setting

Guillain-Barré syndrome (GBS) is a rare but serious neurological disorder that often leads to significant morbidity and mortality. This study aimed to investigate the clinical characteristics, epidemiological trends, and outcomes of GBS patients admitted to Jimma Medical Center (JMC). This was a mixed retrospective and prospective study conducted at JMC, a tertiary teaching hospital in southwest Ethiopia. Medical records of patients admitted with GBS from October 2017 to August 2021 were retrospectively reviewed, while patients admitted between September 2021 and October 2024 were prospectively recruited. Data were collected on socio-demographic information, clinical presentation, diagnostic tests, treatment, and discharge outcomes. Descriptive statistics, Kaplan-Meier survival analysis, and Geographic Information System mapping were used to analyze the data. A total of 93 patients with GBS were admitted during the 7 year study period. The median age was 30 years (IQR: 23-40), and most patients (54.8%) were within the 15 to 30 age group. Admissions peaked between November and January each year, with notable increase since the end of 2021. Among the 54 patients with complete medical records, the most common presenting symptoms were extremity weakness (92.6%) and difficulty walking (59.3%), while ascending paralysis was observed in 70.4% of cases. Bulbar symptoms occurred in 31.5% of patients. Preceding infections, particularly flu-like symptoms, were reported by 46.3% of them. Overall, 77.8% required ICU care, with 42.6% needing mechanical ventilation. Intravenous immunoglobulin therapy was administered to only 14.8% of patients. The in-hospital mortality rate was 25.9%, and complications such as quadriplegia (46.3%) and depression (35.2%) were common. Patients who required mechanical ventilation faced a significantly higher risk of mortality (P < .05), with survival rates dropping to 0% by day 165 in this group. This study highlights a significant burden of GBS at JMC, with notable seasonal trends, high ICU admission rates, and substantial mortality. Early diagnoses, improved access to immunotherapy, and enhanced supportive care, especially for those with respiratory failure, are critical to improving outcomes. The findings underscore the need for robust public health strategies to prevent, manage, and mitigate the impact of GBS, particularly in low-resource settings like Ethiopia.