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Updated: May 23, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Early Childhood Neurodevelopmental Outcomes After Early Infant Invasive Group B Streptococcal Infection in Uganda
Samantha Sadoo1,2, Carol Nanyunja1,3, Mary Kyohere4,5
1London School of Hygiene and Tropical Medicine, London, UK.
Insights
Infant Group B streptococcal (GBS) sepsis survivors in Uganda showed significantly lower cognitive and language scores. These children also faced higher rates of neurodevelopmental impairment and undernutrition, highlighting the need for long-term follow-up.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurodevelopmental Disabilities
Background:
- Group B streptococcal (GBS) sepsis is a major cause of infant mortality and long-term neurodevelopmental issues.
- Limited data exist on the outcomes of invasive GBS infection survivors in low- and middle-income countries.
- This study focuses on 2-year neurodevelopmental and growth outcomes following GBS sepsis in Uganda.
Purpose of the Study:
- To assess the neurodevelopmental and growth outcomes of infants surviving GBS sepsis in Uganda.
- To compare outcomes between GBS sepsis survivors and a matched cohort without GBS sepsis.
- To identify the long-term impact of GBS sepsis on child development in a Sub-Saharan African population.
Main Methods:
- Infants with culture-proven GBS sepsis (under 3 months) and a matched comparison group were recruited in Kampala, Uganda.
- Neurodevelopmental impairment was assessed up to 24 months corrected age using the Bayley Scales of Infant Development and Hammersmith Infant Neurological Examination.
- Growth parameters including weight, height, and head circumference were measured.
Main Results:
- GBS sepsis survivors (n=16) had lower cognitive and language scores compared to the non-GBS cohort (n=59).
- Moderate to severe neurodevelopmental impairment affected 31% of GBS survivors versus 8.5% of controls.
- GBS sepsis survivors were more likely to experience undernutrition (25% vs 10%), particularly those with cerebral palsy.
Conclusions:
- Infant GBS sepsis survivors in this Sub-Saharan African population exhibit poorer neurodevelopmental and growth outcomes.
- There is a higher incidence of neurodevelopmental impairment and undernutrition among GBS sepsis survivors.
- Long-term follow-up programs are crucial for monitoring GBS sepsis survivors for developmental difficulties and facilitating early intervention.
Background:
Group B streptococcal (GBS) sepsis during infancy is a leading cause of child mortality and an important contributor to long-term neurodisability. Data on outcomes among invasive GBS infection survivors in low- and middle-income countries are limited. We present 2-year neurodevelopment and growth outcomes after GBS sepsis in Uganda.
Methods:
Participants were infants with culture-proven GBS sepsis <3 months of age and a gestationally matched comparison cohort of infants who did not have GBS sepsis in Kampala, Uganda. Neurodevelopmental impairment up to 24 months (corrected age) was assessed using the Bayley Scales of Infant Development and Hammersmith Infant Neurological Examination. Weight, height, mid-upper arm circumference, and occipito-frontal circumference were measured.
Results:
Neurodevelopmental outcome data were available for 16 survivors of GBS sepsis and 59 comparison children. Among survivors of GBS sepsis, cognitive and language scores were lower (median difference [interquartile range], -5 [-10 to 0] and -8 [-15 to -2], respectively). Moderate to severe neurodevelopmental impairment occurred in 31% (5/16) in the GBS cohort compared with 8.5% (5/59) in the non-GBS cohort. Three children with neurodevelopmental impairment had cerebral palsy (bilateral spasticity), and 2 had global developmental delay without cerebral palsy. GBS sepsis survivors were more likely to have undernutrition compared with comparison children (25% vs 10%), largely due to severe undernutrition among those with cerebral palsy.
Conclusions:
In this Sub-Saharan African population, survivors of infant GBS sepsis were more likely to have impaired neurodevelopmental and growth outcomes compared with children who did not have GBS sepsis. GBS sepsis survivors should be included in long-term follow-up programs to monitor for neurodevelopmental difficulties and initiate early referrals to support services.
