Michelle Kvalsund, MD

Michigan State University, East Lansing, MI

2019 ANF Development Grant

  • $100,000 paid over 2 years

Project Title

Prevalence and Spectrum of Adult Acute Flaccid Paralysis in Zambia

Project Summary

Acute Flaccid Paralysis (AFP) is a sudden onset of weakness of paralysis of the limbs over just hours or days. The condition has many causes and can be life-threatening by causing weakness of respiratory muscles. These cases require support for breathing in an intensive care unit. Polio is a well-known cause of AFP that is surveilled very closely around the world, but other causes of AFP are not monitored consistently across geographic regions. There is need to improve knowledge about the frequency and causes of AFP, especially in sub-Saharan Africa where very few studies have previously been conducted. Improved surveillance may allow early identification of new emerging diseases and allow interventions that can reduce the spread of illnesses regionally and around the globe. 

In North America, the most common type of AFP, called Guillain-Barré Syndrome (GBS), occurs in about 1 person per 100,000 people and results in substantial personal and health system costs. Therapies for these disorders cannot prevent GBS, but may mitigate severity and reduce intensive care stays. Sadly, about 3.5% of afflicted persons continue to die from complications of the disorder. Survivors face long recovery periods, and some will remain permanently disabled with inability to walk or perform day-to-day activities. New therapeutic strategies are needed. The study of GBS in different regions can provide additional clues about the biologic processes that lead to paralysis and offer promise for new scientific advances for management and treatment that can benefit patients both locally and abroad. 

This study will evaluate AFP at a large urban hospital in Lusaka, Zambia over a 2-year period. The overarching goal of the study is to define how common AFP is among adult patients in Zambia, and define the most common AFP causes and risk factors. This important information will allow scientists to gain baseline data on the condition in sub-Saharan Africa that can instruct additional research studies and enhance surveillance methods.