South African Children: A Matched Cohort Study of Neurodevelopmental Impairment in Survivors of Invasive Group B Streptococcus Disease Aged 5 to 8 Years.

Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Volume: 74

Issue: Suppl_1

Year of Publication: 2022

Affiliated Institutions:  Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK. Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, Western Cape, South Africa. South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract summary 

Invasive group B Streptococcus (iGBS) sepsis and meningitis are important causes of child mortality, but studies on neurodevelopmental impairment (NDI) after iGBS are limited. Using Griffiths Mental Development Scales-Extended Revised (GMDS-ER), we described NDI in iGBS survivors and non-iGBS children from South Africa, as part of a 5-country study.We identified children aged 5-8 years with a history of iGBS and children with no history of iGBS between October 2019 and January 2021. Children were matched on sex, and birth data (month, year) (matched cohort study). Moderate or Severe NDI was the primary outcome as a composite of GMDS-ER motor, GMDS-ER cognition, hearing, and vision. Secondary outcomes included mild NDI, any emotional-behavioral problems, and GMDS-ER developmental quotients (DQ) calculated by dividing the age equivalent GMDS-ER score by the chronological age.In total, 160 children (iGBS survivors, 43; non-iGBS, 117) were assessed. Among iGBS survivors 13 (30.2%) had meningitis, and 30 (69.8%) had sepsis. Six (13.9%) iGBS survivors, and 5 (4.3%) non-iGBS children had moderate or severe NDI. Children who survived iGBS were 5.56 (95% confidence interval [CI]: 1.07-28.93; P = .041) times more likely to have moderate or severe NDI at 5-8 years than non-iGBS children. Compared to the non-iGBS children, iGBS meningitis survivors had a significantly lower global median DQ (P < .05), as well as a lower median DQ for the language GMDS-ER subscale and performance GMDS-ER subscale (P < .05).Children surviving iGBS, particularly meningitis, are more likely to have NDI at 5-8 years compared to non-iGBS children. Further research is required to improve detection and care for at-risk newborns.

Authors & Co-authors:  Harden Lois M LM Leahy Shannon S Lala Sanjay G SG Paul Proma P Chandna Jaya J Lowick Sarah S Mbatha Sibongile S Jaye Tamara T Laughton Barbara B Ghoor Azra A Sithole Pamela P Msayi Jacqueline J Kumalo Ntombifuthi N Msibi Tshepiso N TN Madhi Shabir A SA Lawn Joy E JE Dangor Ziyaad Z

Study Outcome 

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Statistics
Citations :  Madrid L, Seale AC, Kohli-Lynch M, et al. ; Infant GBS Disease Investigator Group. Infant Group B streptococcal disease incidence and serotypes worldwide: systematic review and meta-analyses. Clin Infect Dis 2017; 65:160–72.
Authors :  17
Identifiers
Doi : 10.1093/cid/ciab814
SSN : 1537-6591
Study Population
Male,Female
Mesh Terms
Child
Other Terms
Griffiths Mental Development Scales;group B Streptococcus;neonatal meningitis;neonatal sepsis;neurodevelopment
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States