Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 10;11(Suppl 3):S173-S181.
doi: 10.1093/ofid/ofae602. eCollection 2024 Dec.

Early Childhood Neurodevelopmental Outcomes After Early Infant Invasive Group B Streptococcal Infection in Uganda

Samantha Sadoo  1   2 , Carol Nanyunja  1   3 , Mary Kyohere  4   5 , Hannah G Davies  1   4 , Valerie Tusubira  5 , Cleophas Komugisha  5 , Joseph Peacock  4 , Margaret Sewegaba  6 , Philippa Musoke  5 , Musa Sekikubo  7 , Kirsty Le Doare  3   4   5 , Cally J Tann  1   2   3 ; PROGRESS Study Author Group
Collaborators, Affiliations

Early Childhood Neurodevelopmental Outcomes After Early Infant Invasive Group B Streptococcal Infection in Uganda

Samantha Sadoo et al. Open Forum Infect Dis. .

Abstract

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.

Keywords: Uganda; group B Streptococcus; growth; infant sepsis; neurodevelopment.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. K.L.D. received funding for research at the Institute for Infection and Immunity at St George's, University of London, from Pfizer and MinervaX, for work that is unrelated to this manuscript. She has received no personal funds. All other authors declare no potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow of participants. Abbreviation: iGBS, invasive group B Streptococcus.
See this image and copyright information in PMC

References

    1. United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME) . Level and Trends in Child Mortality Report 2019. United Nations; 2019.
    1. Madrid L, Seale AC, Kohli-Lynch M, et al. Infant group B streptococcal disease incidence and serotypes worldwide: systematic review and meta-analyses. Clin Infect Dis 2017; 65(Suppl 2):S160–72. - PMC - PubMed
    1. United Nations . The Global Strategy for Women's, Children's and Adolescents’ Health (2016-2030). United Nations; 2015. Available at: https://data.unicef.org/wp-content/uploads/2017/02/EWEC_globalstrategyre.... Accessed October 23, 2023.
    1. Global, regional, and national burden of brain and other CNS cancer, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18:376–93. - PMC - PubMed
    1. World Health Organization, World Bank, UNICEF . Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. 2018. Available at: https://nurturing-care.org/ Accessed October 23, 2023.

LinkOut - more resources