Zahirul Islam, PhD

GHES LMIC Fellow 2015-2016

Home Institution: 
International Centre for Diarrhoeal Disease Research, Bangladesh
U.S. Institution: Stanford University

Project Title: Guillain-Barre syndrome in Bangladesh: Comprehensive analysis of bacterial risk factors after Campylobacter jejuni infection.

Around the world, people suffer from Guillain-Barre syndrome (GBS), yet the situation is especially grave in low income countries. Previous studies from our group showed that in Bangladesh, GBS causes an exceptionally high burden of disease; similar figures might occur in other low-income countries where a large proportion of the current world population lives.

In Bangladesh, the only specific treatment for severe GBS patients is either plasma exchange or intravenous immunoglobulin (IVIg) [2]; both the options are unaffordable for most Bangladeshi patients considering the low per capita income (<US$1000). The majority (85%) of GBS patients in Bangladesh do not receive one of these specific treatments. Not surprisingly, the mortality rate of GBS in Bangladesh is much higher than that of patients in developed countries [3].

Considering the significant mortality and morbidity of GBS in Bangladesh, it is of utmost importance to identify the risk factors that improve the management and outcomes of GBS patients in developing countries. People living in urban slums are at the highest risk of illnesses due to high exposure of pathogenic microorganisms via contaminated food and water. Because 60% of the total population of Dhaka city are living in slums, indicators of good urban health of a megacity like Dhaka are largely dependent on the goodness of slum health. Knowledge about the bacterial risk factors for the development of GBS might improve the management strategies of GBS patients with poor outcome; and it would help us to develop new intervention strategy to prevent this disease.

Main objective:
The main objective of this project is to investigate LOS locus classes, cstII polymorphism and ganglioside-like LOSs to identify risk factors for the development of GBS.

Specific objectives:
(1) To analyze LOS locus classes comprehensively among C. jejuni isolated from GBS and enteritis patients, and healthy controls.
(2) To determine the genetic polymorphism (sialyltransferase gene cstII) of C. jejuni that determines autoantibody reactivity, and clinical phenotype of GBS.
(3) To determine the ganagliosides in serum samples from GBS patients.
(4) To determine the antibodies against C. jejuni LOS in serum samples from GBS patients.

Dr. Islam and colleagues in their research facility.