Neurodevelopmental Impairment in Children after Group B Streptococcal Disease Worldwide

Systematic Review and Meta-analyses

Maya Kohli-Lynch, Neal J. Russell, Anna C. Seale, Ziyaad Dangor, Cally J. Tann, Carol J. Baker, Linda Bartlett, Clare Cutland, Michael G. Gravett, Paul T. Heath, Margaret Ip, Kirsty Le Doare, Shabir A. Madhi, Craig E. Rubens, Samir K. Saha, Stephanie Schrag, Ajoke Sobanjo-Ter Meulen, Johan Vekemans, Catherine O'Sullivan, Firdose Nakwa & 8 others Hechmi Ben Hamouda, Habib Soua, Kyriaki Giorgakoudi, Shamez Ladhani, Theresa Lamagni, Hilary Rattue, Caroline Trotter, Joy E. Lawn

Research output: Contribution to journalReview article

Abstract

Survivors of infant group B streptococcal (GBS) disease are at risk of neurodevelopmental impairment (NDi), a burden not previously systematically quantified. This is the 10th of 11 articles estimating the burden of GBS disease. Here we aimed to estimate NDi in survivors of infant GBS disease. Methods. We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data on the risk of NDi after invasive GBS disease in infants <90 days of age. We did meta-analyses to derive pooled estimates of the percentage of infants with NDi following GBS meningitis. Results. We identified 6127 studies, of which 18 met eligibility criteria, all from middle-or high-income contexts. All 18 studies followed up survivors of GBS meningitis; only 5 of these studies also followed up survivors of GBS sepsis and were too few to pool in a meta-analysis. Of meningitis survivors, 32% (95% CI, 25%-38%) had NDi at 18 months of follow-up, including 18% (95% CI, 13%-22%) with moderate to severe NDi. Conclusions. GBS meningitis is an important risk factor for moderate to severe NDi, affecting around 1 in 5 survivors. However, data are limited, and we were unable to estimate NDi after GBS sepsis. Comparability of studies is difficult due to methodological differences including variability in timing of clinical reviews and assessment tools. Follow-up of clinical cases and standardization of methods are essential to fully quantify the total burden of NDi associated with GBS disease, and inform program priorities.

Original languageEnglish (US)
Pages (from-to)S190-S199
JournalClinical Infectious Diseases
Volume65
DOIs
StatePublished - Jan 1 2017

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Survivors
Meta-Analysis
Meningitis
Sepsis
PubMed
Information Systems
Libraries
Health

Keywords

  • disability
  • estimate.
  • Group B Streptococcus
  • impairment
  • infants

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Kohli-Lynch, M., Russell, N. J., Seale, A. C., Dangor, Z., Tann, C. J., Baker, C. J., ... Lawn, J. E. (2017). Neurodevelopmental Impairment in Children after Group B Streptococcal Disease Worldwide: Systematic Review and Meta-analyses. Clinical Infectious Diseases, 65, S190-S199. https://doi.org/10.1093/cid/cix663

Neurodevelopmental Impairment in Children after Group B Streptococcal Disease Worldwide : Systematic Review and Meta-analyses. / Kohli-Lynch, Maya; Russell, Neal J.; Seale, Anna C.; Dangor, Ziyaad; Tann, Cally J.; Baker, Carol J.; Bartlett, Linda; Cutland, Clare; Gravett, Michael G.; Heath, Paul T.; Ip, Margaret; Le Doare, Kirsty; Madhi, Shabir A.; Rubens, Craig E.; Saha, Samir K.; Schrag, Stephanie; Sobanjo-Ter Meulen, Ajoke; Vekemans, Johan; O'Sullivan, Catherine; Nakwa, Firdose; Ben Hamouda, Hechmi; Soua, Habib; Giorgakoudi, Kyriaki; Ladhani, Shamez; Lamagni, Theresa; Rattue, Hilary; Trotter, Caroline; Lawn, Joy E.

In: Clinical Infectious Diseases, Vol. 65, 01.01.2017, p. S190-S199.

Research output: Contribution to journalReview article

Kohli-Lynch, M, Russell, NJ, Seale, AC, Dangor, Z, Tann, CJ, Baker, CJ, Bartlett, L, Cutland, C, Gravett, MG, Heath, PT, Ip, M, Le Doare, K, Madhi, SA, Rubens, CE, Saha, SK, Schrag, S, Sobanjo-Ter Meulen, A, Vekemans, J, O'Sullivan, C, Nakwa, F, Ben Hamouda, H, Soua, H, Giorgakoudi, K, Ladhani, S, Lamagni, T, Rattue, H, Trotter, C & Lawn, JE 2017, 'Neurodevelopmental Impairment in Children after Group B Streptococcal Disease Worldwide: Systematic Review and Meta-analyses', Clinical Infectious Diseases, vol. 65, pp. S190-S199. https://doi.org/10.1093/cid/cix663
Kohli-Lynch, Maya ; Russell, Neal J. ; Seale, Anna C. ; Dangor, Ziyaad ; Tann, Cally J. ; Baker, Carol J. ; Bartlett, Linda ; Cutland, Clare ; Gravett, Michael G. ; Heath, Paul T. ; Ip, Margaret ; Le Doare, Kirsty ; Madhi, Shabir A. ; Rubens, Craig E. ; Saha, Samir K. ; Schrag, Stephanie ; Sobanjo-Ter Meulen, Ajoke ; Vekemans, Johan ; O'Sullivan, Catherine ; Nakwa, Firdose ; Ben Hamouda, Hechmi ; Soua, Habib ; Giorgakoudi, Kyriaki ; Ladhani, Shamez ; Lamagni, Theresa ; Rattue, Hilary ; Trotter, Caroline ; Lawn, Joy E. / Neurodevelopmental Impairment in Children after Group B Streptococcal Disease Worldwide : Systematic Review and Meta-analyses. In: Clinical Infectious Diseases. 2017 ; Vol. 65. pp. S190-S199.
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abstract = "Survivors of infant group B streptococcal (GBS) disease are at risk of neurodevelopmental impairment (NDi), a burden not previously systematically quantified. This is the 10th of 11 articles estimating the burden of GBS disease. Here we aimed to estimate NDi in survivors of infant GBS disease. Methods. We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data on the risk of NDi after invasive GBS disease in infants <90 days of age. We did meta-analyses to derive pooled estimates of the percentage of infants with NDi following GBS meningitis. Results. We identified 6127 studies, of which 18 met eligibility criteria, all from middle-or high-income contexts. All 18 studies followed up survivors of GBS meningitis; only 5 of these studies also followed up survivors of GBS sepsis and were too few to pool in a meta-analysis. Of meningitis survivors, 32{\%} (95{\%} CI, 25{\%}-38{\%}) had NDi at 18 months of follow-up, including 18{\%} (95{\%} CI, 13{\%}-22{\%}) with moderate to severe NDi. Conclusions. GBS meningitis is an important risk factor for moderate to severe NDi, affecting around 1 in 5 survivors. However, data are limited, and we were unable to estimate NDi after GBS sepsis. Comparability of studies is difficult due to methodological differences including variability in timing of clinical reviews and assessment tools. Follow-up of clinical cases and standardization of methods are essential to fully quantify the total burden of NDi associated with GBS disease, and inform program priorities.",
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T2 - Systematic Review and Meta-analyses

AU - Kohli-Lynch, Maya

AU - Russell, Neal J.

AU - Seale, Anna C.

AU - Dangor, Ziyaad

AU - Tann, Cally J.

AU - Baker, Carol J.

AU - Bartlett, Linda

AU - Cutland, Clare

AU - Gravett, Michael G.

AU - Heath, Paul T.

AU - Ip, Margaret

AU - Le Doare, Kirsty

AU - Madhi, Shabir A.

AU - Rubens, Craig E.

AU - Saha, Samir K.

AU - Schrag, Stephanie

AU - Sobanjo-Ter Meulen, Ajoke

AU - Vekemans, Johan

AU - O'Sullivan, Catherine

AU - Nakwa, Firdose

AU - Ben Hamouda, Hechmi

AU - Soua, Habib

AU - Giorgakoudi, Kyriaki

AU - Ladhani, Shamez

AU - Lamagni, Theresa

AU - Rattue, Hilary

AU - Trotter, Caroline

AU - Lawn, Joy E.

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