Bramugy, Justina; Mucasse, Humberto; Massora, Sergio; Vitorino, Pio; Aerts, Céline; Mandomando, Inacio; Paul, Proma; Chandna, Jaya; Seedat, Farah; Lawn, Joy E; +2 more... Bardají, Azucena; Bassat, Quique; (2022) Short- and Long-term Outcomes of Group B Streptococcus Invasive Disease in Mozambican Children: Results of a Matched Cohort and Retrospective Observational Study and Implications for Future Vaccine Introduction. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 74 (Suppl_). S14-S23. ISSN 1058-4838 DOI: https://doi.org/10.1093/cid/ciab793
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Abstract
BACKGROUND: Invasive group B Streptococcus disease (iGBS) in infancy, including meningitis or sepsis, carries a high risk of mortality and neurodevelopmental impairment (NDI). We present data on iGBS from 2 decades of surveillance in Manhiça, Mozambique, with a focus on NDI. METHODS: Morbidity surveillance databases in a rural Mozambican district hospital were screened for iGBS cases. From February 2020 to March 2021, surviving iGBS patients (n = 39) plus age- and sex-matched children without iGBS (n = 119) were assessed for neurocognitive development, vision, and hearing. The role of GBS in stillbirths and infant deaths was investigated using minimally invasive tissue sampling (MITS). RESULTS: Ninety iGBS cases were included, with most children being <3 months of age (85/90). The in-hospital case fatality rate was 14.4% (13/90), increasing to 17.8% (3 additional deaths) when considering mortality during the 6 months postdiagnosis. Fifty percent of the iGBS exposed infants and 10% of those unexposed showed any NDI. Surviving GBS conferred a 11-fold increased adjusted odds of moderate/severe NDI (odds ratio, 2.8 [95% confidence interval, .92-129.74]; P = .06) in children aged 0-5 years. For older children (6-18 years), no differences in NDI were found between exposed and unexposed. Motor domain was the most affected among young GBS survivors. Three stillbirths and 4 early neonatal deaths (of the 179 MITS performed) were attributed to iGBS. CONCLUSIONS: In absence of preventive strategies, such as intrapartum antibiotics, iGBS remains a significant cause of perinatal and infant disease and death. GBS also causes major longer-term neurodevelopmental sequelae, altogether justifying the need for maternal GBS vaccination strategies to increase perinatal and infant survival.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Research Centre |
Centre for Maternal, Reproductive and Child Health (MARCH) Maternal and Newborn Health Group |
PubMed ID | 34725690 |
Elements ID | 167139 |
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Filename: Short- and Long-term Outcomes of Group B Streptococcus Invasive Disease in Mozambican Children Results of a Matched Cohort a.pdf
Licence: Creative Commons: Attribution 4.0
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