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Infectious pathogens associated with stillbirth and under-five mortality by sickle cell disease in Western Kenya: a

Morgan Otundo Wasilwa1,2, Valentine Simiyu3, Fredrick Onduru3

  • 1Department of Microbiology and Immunology, University of Cape Coast, Cape Coast, Ghana. wasilwamorgan@gmail.com.

BMC Infectious Diseases
|July 1, 2026
PubMed

Insights

Infectious pathogens significantly contribute to stillbirths and under-five deaths in Western Kenya, particularly in children with sickle cell disease (SCD). Targeted infection prevention and management are crucial for this vulnerable population.

Area of Science:

  • Global Health
  • Infectious Diseases
  • Pediatrics
  • Genetics

Background:

  • Infectious pathogens are a major cause of stillbirths and under-five mortality in resource-limited settings.
  • Children with sickle cell disease (SCD) face increased susceptibility to infections due to compromised immunity.
  • This study investigated infectious agents linked to mortality in Western Kenya, focusing on the impact of SCD.

Purpose of the Study:

  • To identify infectious pathogens associated with stillbirths and under-five deaths in Western Kenya.
  • To determine the role of sickle cell disease (SCD) and sickle cell trait in infection outcomes.
  • To inform public health strategies for infection prevention and management in vulnerable populations.

Main Methods:

  • Analysis of 1,332 stillbirths and under-five deaths from the Kenya Child Health and Mortality Prevention Surveillance (CHAMPS) network.
  • Minimally invasive tissue sampling (MITS) with real-time PCR and culturing for pathogen detection.
  • Sickle cell status assessment using point-of-care testing, HPLC, and pathological diagnosis.

Main Results:

  • Infectious pathogens were identified in 37.5% of cases, with higher prevalence in under-five deaths (51.1%) than stillbirths (4.1%).
  • Sickle cell disease (SCD) was present in 3.5% and sickle cell trait in 19.2% of cases.
  • Infection prevalence was significantly higher in SCD (60.9%) compared to sickle cell trait (25.8%).
  • Leading pathogens included Plasmodium falciparum, Klebsiella pneumoniae, and Streptococcus pneumoniae, with varying frequencies between SCD/trait and non-SCD/trait groups.

Conclusions:

  • Infectious pathogens are strongly linked to stillbirth and under-five mortality in Western Kenya.
  • Strengthening infection prevention, diagnosis, and management is essential during pregnancy and early childhood.
  • Targeted preventive care strategies are needed for high-risk groups, including individuals with SCD.
Abstract

Keywords:
Infectious pathogensLMICsSickle cell diseaseStillbirthUnder-five mortality

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