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

Sadoo, S; Nanyunja, C; Kyohere, M; Davies, HG; Tusubira, V; Komugisha, C; Peacock, J; Sewegaba, M; Musoke, P; Sekikubo, M; et al. Sadoo, S; Nanyunja, C; Kyohere, M; Davies, HG; Tusubira, V; Komugisha, C; Peacock, J; Sewegaba, M; Musoke, P; Sekikubo, M; Le Doare, K; Tann, CJ; PROGRESS Study Author Grp, A (2025) Early Childhood Neurodevelopmental Outcomes After Early Infant Invasive Group B Streptococcal Infection in Uganda. OPEN FORUM INFECTIOUS DISEASES, 11. S173-S181. ISSN 2328-8957 https://doi.org/10.1093/ofid/ofae602
SGUL Authors: Le Doare, Kirsty Karampatsas, Konstantinos

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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.

Item Type: Article
Additional Information: © The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: PROGRESS Study Author Group, infant sepsis, group B Streptococcus, growth, neurodevelopment, Uganda
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: OPEN FORUM INFECTIOUS DISEASES
ISSN: 2328-8957
Dates:
DateEvent
10 March 2025Published
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
OPP1189053Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
16/136/46National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Web of Science ID: WOS:001440157800001
URI: https://openaccess.sgul.ac.uk/id/eprint/117312
Publisher's version: https://doi.org/10.1093/ofid/ofae602

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