Challenges in reducing group B Streptococcus disease in African settings.
Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis in high-income settings and is associated with high rates of neonatal mortality and morbidity. There is now increasing evidence to suggest that there is a high GBS disease burden in resource-limited countries, and it is therefore critically important to identify suitable and practical preventive strategies. In Europe and North America, intrapartum antibiotic prophylaxis (IAP) has led to a dramatic reduction of early-onset GBS disease. However, the methods for identifying pregnant women who should receive IAP and how to reduce late-onset GBS disease are not without controversy and are challenging for most sub-Saharan African countries. GBS vaccines are approaching phase III trials but are still under development. This review aims to explore the current evidence related to strategies for reducing invasive GBS disease in an African setting, the development of a GBS vaccine and whether preventative measures against GBS disease can be practically implemented.
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.
Yo
Y
Nishihara
Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa.|Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa.|Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa.
Ziyaad
Z
Dangor
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.|Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
Neil
N
French
Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa.|Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa.
Shabir
S
Madhi
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.|Division of Infection and Immunity, University College London, London, UK.
Robert
R
Heyderman
D000349:Africa; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D060085:Coinfection / Q000150:complications; D042241:Early Diagnosis; D005260:Female; D015658:HIV Infections / Q000150:complications; D006295:Health Resources / Q000600:supply & distribution; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D060888:Real-Time Polymerase Chain Reaction; D018570:Risk Assessment; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D022541:Streptococcal Vaccines
D000900:Anti-Bacterial Agents; D022541:Streptococcal Vaccines
Africa; GBS vaccine; group B streptococcus; intrapartum antibiotic prophylaxis; neonatal sepsis