Le SIDA en Afrique subsaharienne (serveur d'exploration)

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Maternal colonisation with Streptococcus agalactiae, and associated stillbirth and neonatal disease in coastal Kenya

Identifieur interne : 001B26 ( Pmc/Corpus ); précédent : 001B25; suivant : 001B27

Maternal colonisation with Streptococcus agalactiae, and associated stillbirth and neonatal disease in coastal Kenya

Auteurs : Anna C. Seale ; Angela C. Koech ; Anna E. Sheppard ; Hellen C. Barsosio ; Joyce Langat ; Emily Anyango ; Stella Mwakio ; Salim Mwarumba ; Susan C. Morpeth ; Kirimi Anampiu ; Alison Vaughan ; Adam Giess ; Polycarp Mogeni ; Leahbell Walusuna ; Hope Mwangudzah ; Doris Mwanzui ; Mariam Salim ; Bryn Kemp ; Caroline Jones ; Neema Mturi ; Benjamin Tsofa ; Edward Mumbo ; David Mulewa ; Victor Bandika ; Musimbi Soita ; Maureen Owiti ; Norris Onzere ; A Sarah Walker ; Stephanie J. Schrag ; Stephen H. Kennedy ; Greg Fegan ; Derrick W. Crook ; James A. Berkley

Source :

RBID : PMC:4936517

Abstract

Streptococcus agalactiae (Group B Streptococcus, GBS) causes neonatal disease and stillbirth, but its burden in sub-Saharan Africa is uncertain. We assessed maternal recto-vaginal GBS colonisation (7967 women), stillbirth and neonatal disease. Whole genome sequencing was used to determine serotypes, sequence types (ST), and phylogeny. We found low maternal GBS colonisation prevalence (934/7967, 12%), but comparatively high incidence of GBS-associated stillbirth and early onset neonatal disease (EOD) in hospital (0.91(0.25-2.3)/1000 births; 0.76(0.25-1.77)/1000 live-births respectively). However, using a population denominator, EOD incidence was considerably reduced (0.13(0.07-0.21)/1000 live-births). Treated cases of EOD had very high case fatality (17/36, 47%), especially within 24 hours of birth, making under-ascertainment of community-born cases highly likely, both here and in similar facility-based studies. Maternal GBS colonisation was less common in women with low socio-economic status, HIV infection and undernutrition, but when GBS-colonised, they were more likely colonised by the most virulent clone, CC17. CC17 accounted for 267/915(29%) of maternal colonising (265/267(99%) serotype III, 2/267(0.7%) serotype IV), and 51/73(70%) of neonatal disease cases (all serotype III). Trivalent (Ia/II/III) and pentavalent (Ia/Ib/II/III/V) vaccines would cover 71/73(97%) and 72/73(99%) of disease-causing serotypes respectively. Serotype IV should be considered for inclusion, with evidence of capsular switching in CC17 strains.


Url:
DOI: 10.1038/nmicrobiol.2016.67
PubMed: 27572968
PubMed Central: 4936517

Links to Exploration step

PMC:4936517

Le document en format XML

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<title xml:lang="en">Maternal colonisation with
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, and associated stillbirth and neonatal disease in coastal Kenya</title>
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<name sortKey="Seale, Anna C" sort="Seale, Anna C" uniqKey="Seale A" first="Anna C" last="Seale">Anna C. Seale</name>
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<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
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<name sortKey="Koech, Angela C" sort="Koech, Angela C" uniqKey="Koech A" first="Angela C" last="Koech">Angela C. Koech</name>
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<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
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<name sortKey="Barsosio, Hellen C" sort="Barsosio, Hellen C" uniqKey="Barsosio H" first="Hellen C" last="Barsosio">Hellen C. Barsosio</name>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<name sortKey="Langat, Joyce" sort="Langat, Joyce" uniqKey="Langat J" first="Joyce" last="Langat">Joyce Langat</name>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
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<author>
<name sortKey="Anyango, Emily" sort="Anyango, Emily" uniqKey="Anyango E" first="Emily" last="Anyango">Emily Anyango</name>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
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<author>
<name sortKey="Mwakio, Stella" sort="Mwakio, Stella" uniqKey="Mwakio S" first="Stella" last="Mwakio">Stella Mwakio</name>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<author>
<name sortKey="Mwarumba, Salim" sort="Mwarumba, Salim" uniqKey="Mwarumba S" first="Salim" last="Mwarumba">Salim Mwarumba</name>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<name sortKey="Morpeth, Susan C" sort="Morpeth, Susan C" uniqKey="Morpeth S" first="Susan C" last="Morpeth">Susan C. Morpeth</name>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
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<affiliation>
<nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, UK</nlm:aff>
</affiliation>
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<name sortKey="Anampiu, Kirimi" sort="Anampiu, Kirimi" uniqKey="Anampiu K" first="Kirimi" last="Anampiu">Kirimi Anampiu</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<author>
<name sortKey="Vaughan, Alison" sort="Vaughan, Alison" uniqKey="Vaughan A" first="Alison" last="Vaughan">Alison Vaughan</name>
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<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
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<author>
<name sortKey="Giess, Adam" sort="Giess, Adam" uniqKey="Giess A" first="Adam" last="Giess">Adam Giess</name>
<affiliation>
<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mogeni, Polycarp" sort="Mogeni, Polycarp" uniqKey="Mogeni P" first="Polycarp" last="Mogeni">Polycarp Mogeni</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Walusuna, Leahbell" sort="Walusuna, Leahbell" uniqKey="Walusuna L" first="Leahbell" last="Walusuna">Leahbell Walusuna</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<author>
<name sortKey="Mwangudzah, Hope" sort="Mwangudzah, Hope" uniqKey="Mwangudzah H" first="Hope" last="Mwangudzah">Hope Mwangudzah</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<author>
<name sortKey="Mwanzui, Doris" sort="Mwanzui, Doris" uniqKey="Mwanzui D" first="Doris" last="Mwanzui">Doris Mwanzui</name>
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<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
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<name sortKey="Salim, Mariam" sort="Salim, Mariam" uniqKey="Salim M" first="Mariam" last="Salim">Mariam Salim</name>
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<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
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<name sortKey="Kemp, Bryn" sort="Kemp, Bryn" uniqKey="Kemp B" first="Bryn" last="Kemp">Bryn Kemp</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A6">Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name>
<affiliation>
<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mturi, Neema" sort="Mturi, Neema" uniqKey="Mturi N" first="Neema" last="Mturi">Neema Mturi</name>
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<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<author>
<name sortKey="Tsofa, Benjamin" sort="Tsofa, Benjamin" uniqKey="Tsofa B" first="Benjamin" last="Tsofa">Benjamin Tsofa</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
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<name sortKey="Mumbo, Edward" sort="Mumbo, Edward" uniqKey="Mumbo E" first="Edward" last="Mumbo">Edward Mumbo</name>
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<nlm:aff id="A7">County Ministry of Health, Kilifi, Kenya</nlm:aff>
</affiliation>
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<name sortKey="Mulewa, David" sort="Mulewa, David" uniqKey="Mulewa D" first="David" last="Mulewa">David Mulewa</name>
<affiliation>
<nlm:aff id="A7">County Ministry of Health, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Bandika, Victor" sort="Bandika, Victor" uniqKey="Bandika V" first="Victor" last="Bandika">Victor Bandika</name>
<affiliation>
<nlm:aff id="A8">Department of Paediatrics, Coast Provincial General Hospital, Mombasa, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Soita, Musimbi" sort="Soita, Musimbi" uniqKey="Soita M" first="Musimbi" last="Soita">Musimbi Soita</name>
<affiliation>
<nlm:aff id="A9">Department of Obstetrics and Gynaecology, Coast Provincial General Hospital, Mombasa, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Owiti, Maureen" sort="Owiti, Maureen" uniqKey="Owiti M" first="Maureen" last="Owiti">Maureen Owiti</name>
<affiliation>
<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Onzere, Norris" sort="Onzere, Norris" uniqKey="Onzere N" first="Norris" last="Onzere">Norris Onzere</name>
<affiliation>
<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Walker, A Sarah" sort="Walker, A Sarah" uniqKey="Walker A" first="A Sarah" last="Walker">A Sarah Walker</name>
<affiliation>
<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Schrag, Stephanie J" sort="Schrag, Stephanie J" uniqKey="Schrag S" first="Stephanie J" last="Schrag">Stephanie J. Schrag</name>
<affiliation>
<nlm:aff id="A10">Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kennedy, Stephen H" sort="Kennedy, Stephen H" uniqKey="Kennedy S" first="Stephen H" last="Kennedy">Stephen H. Kennedy</name>
<affiliation>
<nlm:aff id="A6">Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Fegan, Greg" sort="Fegan, Greg" uniqKey="Fegan G" first="Greg" last="Fegan">Greg Fegan</name>
<affiliation>
<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Crook, Derrick W" sort="Crook, Derrick W" uniqKey="Crook D" first="Derrick W" last="Crook">Derrick W. Crook</name>
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<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
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<name sortKey="Berkley, James A" sort="Berkley, James A" uniqKey="Berkley J" first="James A" last="Berkley">James A. Berkley</name>
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<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
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<title xml:lang="en" level="a" type="main">Maternal colonisation with
<italic>Streptococcus agalactiae</italic>
, and associated stillbirth and neonatal disease in coastal Kenya</title>
<author>
<name sortKey="Seale, Anna C" sort="Seale, Anna C" uniqKey="Seale A" first="Anna C" last="Seale">Anna C. Seale</name>
<affiliation>
<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Koech, Angela C" sort="Koech, Angela C" uniqKey="Koech A" first="Angela C" last="Koech">Angela C. Koech</name>
<affiliation>
<nlm:aff>NONE</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sheppard, Anna E" sort="Sheppard, Anna E" uniqKey="Sheppard A" first="Anna E" last="Sheppard">Anna E. Sheppard</name>
<affiliation>
<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Barsosio, Hellen C" sort="Barsosio, Hellen C" uniqKey="Barsosio H" first="Hellen C" last="Barsosio">Hellen C. Barsosio</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Langat, Joyce" sort="Langat, Joyce" uniqKey="Langat J" first="Joyce" last="Langat">Joyce Langat</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Anyango, Emily" sort="Anyango, Emily" uniqKey="Anyango E" first="Emily" last="Anyango">Emily Anyango</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mwakio, Stella" sort="Mwakio, Stella" uniqKey="Mwakio S" first="Stella" last="Mwakio">Stella Mwakio</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mwarumba, Salim" sort="Mwarumba, Salim" uniqKey="Mwarumba S" first="Salim" last="Mwarumba">Salim Mwarumba</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Morpeth, Susan C" sort="Morpeth, Susan C" uniqKey="Morpeth S" first="Susan C" last="Morpeth">Susan C. Morpeth</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Anampiu, Kirimi" sort="Anampiu, Kirimi" uniqKey="Anampiu K" first="Kirimi" last="Anampiu">Kirimi Anampiu</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Vaughan, Alison" sort="Vaughan, Alison" uniqKey="Vaughan A" first="Alison" last="Vaughan">Alison Vaughan</name>
<affiliation>
<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Giess, Adam" sort="Giess, Adam" uniqKey="Giess A" first="Adam" last="Giess">Adam Giess</name>
<affiliation>
<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mogeni, Polycarp" sort="Mogeni, Polycarp" uniqKey="Mogeni P" first="Polycarp" last="Mogeni">Polycarp Mogeni</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Walusuna, Leahbell" sort="Walusuna, Leahbell" uniqKey="Walusuna L" first="Leahbell" last="Walusuna">Leahbell Walusuna</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mwangudzah, Hope" sort="Mwangudzah, Hope" uniqKey="Mwangudzah H" first="Hope" last="Mwangudzah">Hope Mwangudzah</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mwanzui, Doris" sort="Mwanzui, Doris" uniqKey="Mwanzui D" first="Doris" last="Mwanzui">Doris Mwanzui</name>
<affiliation>
<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Salim, Mariam" sort="Salim, Mariam" uniqKey="Salim M" first="Mariam" last="Salim">Mariam Salim</name>
<affiliation>
<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kemp, Bryn" sort="Kemp, Bryn" uniqKey="Kemp B" first="Bryn" last="Kemp">Bryn Kemp</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A6">Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name>
<affiliation>
<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mturi, Neema" sort="Mturi, Neema" uniqKey="Mturi N" first="Neema" last="Mturi">Neema Mturi</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Tsofa, Benjamin" sort="Tsofa, Benjamin" uniqKey="Tsofa B" first="Benjamin" last="Tsofa">Benjamin Tsofa</name>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mumbo, Edward" sort="Mumbo, Edward" uniqKey="Mumbo E" first="Edward" last="Mumbo">Edward Mumbo</name>
<affiliation>
<nlm:aff id="A7">County Ministry of Health, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mulewa, David" sort="Mulewa, David" uniqKey="Mulewa D" first="David" last="Mulewa">David Mulewa</name>
<affiliation>
<nlm:aff id="A7">County Ministry of Health, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Bandika, Victor" sort="Bandika, Victor" uniqKey="Bandika V" first="Victor" last="Bandika">Victor Bandika</name>
<affiliation>
<nlm:aff id="A8">Department of Paediatrics, Coast Provincial General Hospital, Mombasa, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Soita, Musimbi" sort="Soita, Musimbi" uniqKey="Soita M" first="Musimbi" last="Soita">Musimbi Soita</name>
<affiliation>
<nlm:aff id="A9">Department of Obstetrics and Gynaecology, Coast Provincial General Hospital, Mombasa, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Owiti, Maureen" sort="Owiti, Maureen" uniqKey="Owiti M" first="Maureen" last="Owiti">Maureen Owiti</name>
<affiliation>
<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Onzere, Norris" sort="Onzere, Norris" uniqKey="Onzere N" first="Norris" last="Onzere">Norris Onzere</name>
<affiliation>
<nlm:aff id="A5">Maternity Department, Kilifi County Hospital, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Walker, A Sarah" sort="Walker, A Sarah" uniqKey="Walker A" first="A Sarah" last="Walker">A Sarah Walker</name>
<affiliation>
<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Schrag, Stephanie J" sort="Schrag, Stephanie J" uniqKey="Schrag S" first="Stephanie J" last="Schrag">Stephanie J. Schrag</name>
<affiliation>
<nlm:aff id="A10">Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kennedy, Stephen H" sort="Kennedy, Stephen H" uniqKey="Kennedy S" first="Stephen H" last="Kennedy">Stephen H. Kennedy</name>
<affiliation>
<nlm:aff id="A6">Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Fegan, Greg" sort="Fegan, Greg" uniqKey="Fegan G" first="Greg" last="Fegan">Greg Fegan</name>
<affiliation>
<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Crook, Derrick W" sort="Crook, Derrick W" uniqKey="Crook D" first="Derrick W" last="Crook">Derrick W. Crook</name>
<affiliation>
<nlm:aff id="A3">Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Berkley, James A" sort="Berkley, James A" uniqKey="Berkley J" first="James A" last="Berkley">James A. Berkley</name>
<affiliation>
<nlm:aff id="A1">Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Nature microbiology</title>
<idno type="eISSN">2058-5276</idno>
<imprint>
<date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
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<front>
<div type="abstract" xml:lang="en">
<p id="P1">
<italic>Streptococcus agalactiae</italic>
(Group B Streptococcus, GBS) causes neonatal disease and stillbirth, but its burden in sub-Saharan Africa is uncertain. We assessed maternal recto-vaginal GBS colonisation (7967 women), stillbirth and neonatal disease. Whole genome sequencing was used to determine serotypes, sequence types (ST), and phylogeny. We found low maternal GBS colonisation prevalence (934/7967, 12%), but comparatively high incidence of GBS-associated stillbirth and early onset neonatal disease (EOD) in hospital (0.91(0.25-2.3)/1000 births; 0.76(0.25-1.77)/1000 live-births respectively). However, using a population denominator, EOD incidence was considerably reduced (0.13(0.07-0.21)/1000 live-births). Treated cases of EOD had very high case fatality (17/36, 47%), especially within 24 hours of birth, making under-ascertainment of community-born cases highly likely, both here and in similar facility-based studies. Maternal GBS colonisation was less common in women with low socio-economic status, HIV infection and undernutrition, but when GBS-colonised, they were more likely colonised by the most virulent clone, CC17. CC17 accounted for 267/915(29%) of maternal colonising (265/267(99%) serotype III, 2/267(0.7%) serotype IV), and 51/73(70%) of neonatal disease cases (all serotype III). Trivalent (Ia/II/III) and pentavalent (Ia/Ib/II/III/V) vaccines would cover 71/73(97%) and 72/73(99%) of disease-causing serotypes respectively. Serotype IV should be considered for inclusion, with evidence of capsular switching in CC17 strains.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">101674869</journal-id>
<journal-id journal-id-type="pubmed-jr-id">44774</journal-id>
<journal-id journal-id-type="nlm-ta">Nat Microbiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Nat Microbiol</journal-id>
<journal-title-group>
<journal-title>Nature microbiology</journal-title>
</journal-title-group>
<issn pub-type="epub">2058-5276</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">27572968</article-id>
<article-id pub-id-type="pmc">4936517</article-id>
<article-id pub-id-type="doi">10.1038/nmicrobiol.2016.67</article-id>
<article-id pub-id-type="manuscript">EMS68774</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Maternal colonisation with
<italic>Streptococcus agalactiae</italic>
, and associated stillbirth and neonatal disease in coastal Kenya</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Seale</surname>
<given-names>Anna C</given-names>
</name>
<degrees>DPhil</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="corresp" rid="CR1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Koech</surname>
<given-names>Angela C</given-names>
</name>
<degrees>MBChB</degrees>
<xref ref-type="aff" rid="A1">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sheppard</surname>
<given-names>Anna E</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Barsosio</surname>
<given-names>Hellen C</given-names>
</name>
<degrees>MBChB</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Langat</surname>
<given-names>Joyce</given-names>
</name>
<degrees>HND</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Anyango</surname>
<given-names>Emily</given-names>
</name>
<degrees>HND</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mwakio</surname>
<given-names>Stella</given-names>
</name>
<degrees>HND</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mwarumba</surname>
<given-names>Salim</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Morpeth</surname>
<given-names>Susan C</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Anampiu</surname>
<given-names>Kirimi</given-names>
</name>
<degrees>HND</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Vaughan</surname>
<given-names>Alison</given-names>
</name>
<degrees>BSc</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Giess</surname>
<given-names>Adam</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mogeni</surname>
<given-names>Polycarp</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Walusuna</surname>
<given-names>Leahbell</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mwangudzah</surname>
<given-names>Hope</given-names>
</name>
<degrees>HND</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mwanzui</surname>
<given-names>Doris</given-names>
</name>
<degrees>RN</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Salim</surname>
<given-names>Mariam</given-names>
</name>
<degrees>RN</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kemp</surname>
<given-names>Bryn</given-names>
</name>
<degrees>DPhil</degrees>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jones</surname>
<given-names>Caroline</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mturi</surname>
<given-names>Neema</given-names>
</name>
<degrees>MRCPCH</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tsofa</surname>
<given-names>Benjamin</given-names>
</name>
<degrees>DPH</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mumbo</surname>
<given-names>Edward</given-names>
</name>
<degrees>BScN</degrees>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mulewa</surname>
<given-names>David</given-names>
</name>
<degrees>MBChB</degrees>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bandika</surname>
<given-names>Victor</given-names>
</name>
<degrees>MMed</degrees>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Soita</surname>
<given-names>Musimbi</given-names>
</name>
<degrees>MMed</degrees>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Owiti</surname>
<given-names>Maureen</given-names>
</name>
<degrees>MMed</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Onzere</surname>
<given-names>Norris</given-names>
</name>
<degrees>MMed</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Walker</surname>
<given-names>A Sarah</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Schrag</surname>
<given-names>Stephanie J</given-names>
</name>
<degrees>DPhil</degrees>
<xref ref-type="aff" rid="A10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kennedy</surname>
<given-names>Stephen H</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Fegan</surname>
<given-names>Greg</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Crook</surname>
<given-names>Derrick W</given-names>
</name>
<degrees>FRCPath</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Berkley</surname>
<given-names>James A</given-names>
</name>
<degrees>FRCPCH</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK</aff>
<aff id="A2">
<label>2</label>
KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</aff>
<aff id="A3">
<label>3</label>
Modernizing Medical Microbiology Consortium, Nuffield Department of Medicine, University of Oxford, UK</aff>
<aff id="A4">
<label>4</label>
London School of Hygiene and Tropical Medicine, London, UK</aff>
<aff id="A5">
<label>5</label>
Maternity Department, Kilifi County Hospital, Kilifi, Kenya</aff>
<aff id="A6">
<label>6</label>
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK</aff>
<aff id="A7">
<label>7</label>
County Ministry of Health, Kilifi, Kenya</aff>
<aff id="A8">
<label>8</label>
Department of Paediatrics, Coast Provincial General Hospital, Mombasa, Kenya</aff>
<aff id="A9">
<label>9</label>
Department of Obstetrics and Gynaecology, Coast Provincial General Hospital, Mombasa, Kenya</aff>
<aff id="A10">
<label>10</label>
Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, USA</aff>
<author-notes>
<corresp id="CR1">
<bold>Corresponding author</bold>
Correspondence to Anna Seale KEMRI-Wellcome Trust, PO Box 230, Kilifi 80108, Kenya. +254 41 7522155
<email>anna.seale@gmail.com</email>
.</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>9</day>
<month>6</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>23</day>
<month>5</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection">
<day>23</day>
<month>5</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>01</day>
<month>1</month>
<year>2017</year>
</pub-date>
<volume>1</volume>
<issue>7</issue>
<fpage>16067</fpage>
<lpage>16067</lpage>
<pmc-comment>elocation-id from pubmed: 10.1038/nmicrobiol.2016.67</pmc-comment>
<abstract>
<p id="P1">
<italic>Streptococcus agalactiae</italic>
(Group B Streptococcus, GBS) causes neonatal disease and stillbirth, but its burden in sub-Saharan Africa is uncertain. We assessed maternal recto-vaginal GBS colonisation (7967 women), stillbirth and neonatal disease. Whole genome sequencing was used to determine serotypes, sequence types (ST), and phylogeny. We found low maternal GBS colonisation prevalence (934/7967, 12%), but comparatively high incidence of GBS-associated stillbirth and early onset neonatal disease (EOD) in hospital (0.91(0.25-2.3)/1000 births; 0.76(0.25-1.77)/1000 live-births respectively). However, using a population denominator, EOD incidence was considerably reduced (0.13(0.07-0.21)/1000 live-births). Treated cases of EOD had very high case fatality (17/36, 47%), especially within 24 hours of birth, making under-ascertainment of community-born cases highly likely, both here and in similar facility-based studies. Maternal GBS colonisation was less common in women with low socio-economic status, HIV infection and undernutrition, but when GBS-colonised, they were more likely colonised by the most virulent clone, CC17. CC17 accounted for 267/915(29%) of maternal colonising (265/267(99%) serotype III, 2/267(0.7%) serotype IV), and 51/73(70%) of neonatal disease cases (all serotype III). Trivalent (Ia/II/III) and pentavalent (Ia/Ib/II/III/V) vaccines would cover 71/73(97%) and 72/73(99%) of disease-causing serotypes respectively. Serotype IV should be considered for inclusion, with evidence of capsular switching in CC17 strains.</p>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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