Introduction:
Guillain-Barre syndrome (GBS) is considered the most common cause of acute flaccid paralysis worldwide.1 Most patients are presented with an antecedent illness, mostly upper respiratory tract infections, which occur in accordance with the onset of motor weakness.2 Numerous endemic and emerging pathogens have been associated with developing GBS worldwide. Several microbes including parasites, bacterial, and viral infection are associated with developing GPS including diseases of high prevalence such as malaria,Campylobacter jejuni infection, Zika virus, and recently COVID-19.3–6 Additionally, the development of GBS is associated with several arboviral diseases including Chikungunya, Crimean–Congo hemorrhagic fever (CCHF), dengue, Rift Valley fever, and West Nile virus.6–10 Other viral infection such as hepatitis E virus, Epstein-Barr virus (EBV), cytomegalovirus (CMV) were involved in the development of GBS.11 Furthermore, other infectious diseases such as Helicobacter pylori, leishmaniasis, and onchocerciasis are also associated with GBS manifestation.12–14
Unfortunately, a wide range of infectious diseases that are associated with GBS are endemic in Sudan, particularly arboviral and emerging viral diseases.15,16 In addition to the recently emerging COVID-19 infection, endemic viruses associated with GBS that are endemic in the country include Chikungunya, CCHF, dengue, and Rift Valley fever as well as EBV, hepatitis E, West Nile, and Zika viruses.17–26 Other Sudan-endemic infectious diseases that are associated with GBS include Helicobacter pylori, leishmaniasis, malaria, and onchocerciasis.17,27–31 However, cases of GBS recently reported in Sudan were associated with COVID-19 infection.32
In this communication, we report a case of a 41-year-old female diagnosed with GBS associated with COVID-19 and malaria co-infection in Sudan.