Maternal carriage of group B streptococci in developing countries

Area of Science:

• Microbiology
• Public Health
• Epidemiology

Background:

• Group B Streptococcus (GBS) is a primary cause of neonatal sepsis in industrialized nations.
• Infrequent identification of GBS in newborns from developing countries prompted this review.
• Investigated GBS colonization rates among women in developing regions to explain lower sepsis reports.

Purpose of the Study:

• To determine GBS colonization prevalence in women from developing countries.
• To assess the impact of study methodologies on reported GBS colonization rates.
• To compare GBS colonization rates across different global regions.

Main Methods:

• Systematic literature review of Medline Express and relevant databases (1975-1996).
• Included studies with adequate methods: vaginal specimen collection and selective broth media.
• Analyzed 34 studies reporting on 7730 women.

Main Results:

• Overall GBS colonization rate was 12.7% across all reviewed studies.
• Adequate methods identified significantly higher colonization rates (17.8%) compared to inadequate methods (RR 2.3).
• Colonization prevalence varied by region: Middle East/North Africa (22%), Asia/Pacific (19%), Sub-Saharan Africa (19%), India/Pakistan (12%), Americas (14%).

Conclusions:

• Geographic variations in GBS colonization exist but are comparable to US rates.
• Specimen collection and microbiological techniques are critical for accurate GBS identification.
• Methodological quality influences the reported prevalence of GBS colonization in women.