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Group B streptococcus incidence in sub-Saharan Africa suggests need for greater prevention
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Findings published in Pediatric Infectious Disease Journal suggested that the incidence of early-onset group B streptococcus in sub-Saharan Africa between 1990 and 2014 was 1.3 per 1,000 births, indicating that better preventive methods are necessary.
“The estimated incidence in sub-Saharan Africa … suggest a burden of disease at least comparable to that found in high-income settings prior to the use of intrapartum antibiotics,” Anushua Sinha, MD, MPH, in the department of health systems and policy at Rutgers School of Public Health, and colleagues wrote. “However, these estimated incidences for sub-Saharan Africa are likely to be underestimates of the true rates due to factors typical of health systems in low-income countries that make it difficult to identify [group B streptococcus (GBS)] disease accurately.”
Currently, researchers are developing a pentavalent vaccine to prevent early-onset and late-onset GBS in newborns, the researchers wrote. However, international health organizations and funders, they said, will need to know the burden of disease, especially in areas with high infant mortality such as sub-Saharan Africa, to better inform their decision-making before introducing a potential vaccine.
To determine the incidence and serotype distribution of maternal GBS, the researchers performed a literature review and meta-analysis of studies between 1990 and 2014. Overall, 17 studies on colonization, nine on disease incidence and six regarding serotype distribution were included.
The researchers found that 21.8% of pregnant women in sub-Saharan Africa were colonized with GBS (95% CI, 18.3-25.5). The incidence of early-onset disease was 1.3 per 1,000 births (95% CI, 0.81-1.9), while late-onset incidence was 0.73 per 1,000 births (95% CI, 0.48-1). The most common serotypes to cause disease were 3 and 1a, followed by serotypes 1b, 2 and 5.
The proportion of mothers colonized with GBS is similar to that found in the United States, the researchers wrote. In addition, the five most common serotypes found also were known to predominate in the U.S. A potential pentavalent vaccine, which would include serotypes 1a, 1b, 2, 3 and 5, would cover 95% of all serotypes that were isolated, the researchers wrote.
“An existing set of antepartum, intrapartum and postpartum strategies to prevent neonatal sepsis and meningitis and its consequences are available,” Sinha and colleagues wrote. “If supported by further disease burden data and cost-effectiveness analyses, investments in these strategies may have the potential to avert cases and save newborn lives in the short- and long-term.” – by Will Offit
Disclosure: Sinha reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures. The study was supported by the Bill and Melinda Gates Foundation.
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