SCOPING REVIEW ON GROUP B STREPTOCOCCUS IN PREGNANT WOMEN AND NEONATES IN AFRICA
Yearly, thousands of newborns across Africa succumb to preventable infections. One of the causes is Group B Streptococcus (GBS), a bacterium often carried unknowingly by pregnant women and transferred to babies during childbirth. Yet, until now, the true scale of the African burden is unclear.
A scoping review was commissioned by an advisory board comprising members of the Kenya Obstetrics and Gynaecology Society (KOGS), Kenya Paediatric Association (KPA) and Lignum Vitae Health (LVH) to aid in deciding priority groups for future maternal intervention in Africa, ultimately reducing neonatal mortality.
The results were striking: GBS was vertically transferred from mother to baby in up to 63.3% of cases. Younger mothers (≤25 years; odds ratio (OR) 2.0, 95% confidence interval (CI) 1.22–3.39), preterm pregnancies (adjusted OR (AOR) 2.77, 95% CI 1.14–6.68), and women living with human immunodeficiency virus (HIV) (OR 2.8–4.22) were more likely to be colonised. However, HIV-positive women on co-trimoxazole were better protected (OR 0.24, 95% CI 0.14–0.39). Maternal colonisation raised the odds of newborn infection by as much as 20 times, but antibiotics during labour reduced this risk significantly (AOR 0.17, 95% CI 0.09–0.30). Overall, maternal colonisation ranged from 1.8% to 64.0%. It is important to note that we did not conduct aggregate or inferential analysis, as it was a scoping review. Unlike in more developed countries, where routine screening and antibiotics are readily available, most African mothers and neonates are not tested for GBS.
The writing is on the wall: Africa needs contextual solutions to GBS. This could include affordable point-of-care tests, more substantial research in neonatal early onset disease (EoD), policy and surveillance, maternal vaccination, and a multidisciplinary approach to raise awareness of GBS, its risks, and its management.
Reference: Were, L. M., Otieno, J. A., Miheso, B., Mayieka, L. M., Alobo, M., Caleb, S. K., & Ochodo, E. (2025). Group B streptococcus in pregnant women and neonates in Africa: a scoping review. BMJ public health, 3(2), e002263. https://doi.org/10.1136/bmjph-2024-002263