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Burden of invasive group B Streptococcus disease and early neurological sequelae in South African infants

Ziyaad Dangor1, Sanjay G Lala2, Clare L Cutland3

  • 1Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa; Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.

Plos One
|April 8, 2015
PubMed

Insights

Group B Streptococcus (GBS) causes significant infant illness, with HIV-exposed infants facing a higher risk of late-onset disease. Vaccination could prevent GBS infections and their severe outcomes in newborns.

Area of Science:

  • Neonatal infectious diseases
  • Epidemiology of GBS
  • HIV and infant health

Background:

  • Group B Streptococcus (GBS) is a major cause of neonatal sepsis and meningitis.
  • High prevalence of HIV in pregnant women presents a unique challenge for GBS disease management.
  • Understanding GBS burden and risk factors is crucial for prevention strategies.

Purpose of the Study:

  • To evaluate the burden of invasive early-onset (EOD) and late-onset (LOD) GBS disease in infants.
  • To assess the risk of neurological sequelae in infants with invasive GBS disease.
  • To investigate the impact of maternal HIV status on GBS disease incidence and outcomes.

Main Methods:

  • A case-control study was conducted in Johannesburg, South Africa.
  • Invasive GBS cases in infants under 3 months were identified through laboratory surveillance.
  • Neurodevelopmental screening was performed on surviving cases and controls at 3 and 6 months of age.

Main Results:

  • 122 cases of invasive GBS disease were identified.
  • HIV-exposed infants had a significantly higher risk of late-onset GBS disease (4.67-fold increase).
  • Neurological sequelae were significantly more common in GBS cases (13.2%) compared to controls (0.4%).

Conclusions:

  • Invasive GBS disease poses a high burden in South Africa, with significant mortality and long-term neurological effects.
  • Increased risk of late-onset GBS disease in infants of HIV-infected mothers contributes to the overall burden.
  • A GBS conjugate vaccine targeting pregnant women could be an effective preventive measure.
Abstract

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