Proma Paul, Research Fellow, London School of Hygiene and Tropical Medicine, has released a new manuscript on the ‘Neurodevelopmental and growth outcomes after invasive Group B Streptococcus in early infancy: A multi-country matched cohort study in South Africa, Mozambique, India, Kenya, and Argentina’, in Lancet eClinical Medicine 2022.

Data are limited regarding long-term consequences of invasive GBS (iGBS) disease in early infancy, especially from low- and middle-income countries (LMIC), where most cases occur. We aimed to estimate the risk of neurodevelopmental impairment (NDI) in children with a history of iGBS disease.

Our study is the first low- and middle-income multi-country data to show a higher risk of neuro-developmental delays in children surviving invasive GBS infections.  These children deserve earlier detection and better healthcare and education for them and their families to thrive. Maternal GBS vaccines could be high impact.”

Proma Paul, Research Fellow, London School of Hygiene & Tropical Medicine

A multi-country matched cohort study was undertaken in South Africa, India, Mozambique, Kenya, and Argentina from October 2019 to April 2021. The exposure of interest was defined as a history of iGBS disease (sepsis or meningitis) before 90 days, amongst children now aged 1.5−18 years. Age and sex-matched, children without a history of GBS were also recruited. Age-appropriate, culturally-adapted assessments were used to define NDI across multiple domains (cognitive, motor, hearing, vision, emotional behaviour, growth). Pooled NDI risk was meta-analysed across sites. The association of iGBS exposure and NDI outcome was estimated using modified with a robust variance estimator.

Our findings suggest that iGBS disease is associated with a higher risk of moderate/severe NDI; however, substantial variation in risk was observed between sites, and data are consistent with a wide range of values. Our study underlines the importance of long-term follow-up for at-risk neonates and more feasible, standardised assessments to facilitate research and clinical practice diagnosis.

Please find access to the manuscript here:

Proma is currently a research fellow and the co-ordinator of the multi-country GBS long term outcome study, which looks at developmental outcomes of survivors of invasive GBS disease in early infancy in Argentina, India, Kenya, Mozambique, and South Africa.

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