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High burden of invasive Streptococcus agalactiae disease in South African infants

Shabir A Madhi1, Kholeka Radebe, Heather Crewe-Brown

  • 1NHLS/Wits/MRC Pneumococcal Diseases Research Unit, University of the Witswaterand, Johannesburg, South Africa. shabirm@mail.saimr.wits.ac.za

Annals of Tropical Paediatrics
|March 22, 2003
PubMed

Insights

Invasive Streptococcus agalactiae (GBS) disease is a significant threat to South African infants, with high mortality rates. Current prevention strategies for GBS disease require urgent reassessment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Invasive Streptococcus agalactiae (Group B Streptococcus - GBS) disease poses a substantial public health challenge in South African infants.
  • Understanding the epidemiology of GBS disease is crucial for developing effective prevention and treatment strategies.

Purpose of the Study:

  • To evaluate the epidemiology of invasive GBS disease in South African children.
  • To identify risk factors for mortality and common serotypes associated with GBS infection.

Main Methods:

  • Retrospective review of medical records of 208 children diagnosed with GBS between January 1997 and December 1999.
  • Classification of GBS cases into early-onset disease (EOD), late-onset disease (LOD), and childhood-onset disease (COD).
  • Analysis of mortality rates, risk factors, and serotype distribution.

Main Results:

  • GBS disease presented as EOD (63%), LOD (31.7%), and COD (5.3%).
  • The incidence of EOD and LOD was 2.06 and 1 per 1000 live births, respectively, with mortality rates of 19.8% and 13.6%.
  • Septic shock, prematurity, low birthweight, and low leukocyte count were significant risk factors for mortality. Serotypes III and Ia were predominant.

Conclusions:

  • Invasive GBS disease is highly prevalent in South African infants, necessitating a re-evaluation of current control measures.
  • Specific serotypes, particularly III and Ia, are major contributors to invasive GBS disease.
  • Targeted interventions and reconsidered public health strategies are essential to reduce the burden of GBS infection.

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