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Coming up: Vaccine to stop bacterial infection stillbirths

Thursday June 22 2017
hospital

A maternity ward at the Kisii Teaching and Referral Hospital in western Kenya. A new vaccine under development seeks to protect babies from Group B streptococcus bacterial infection. PHOTO BENSON MOMANYI | NATION

By CHRISTABEL LIGAMI

Biovac Institute of South Africa and PATH foundation have partnered to develop a vaccine that will help to prevent stillbirths or pre-term deliveries caused by a bacterial infection in a pregnant woman’s vagina or rectum.

The little known Group B streptococcus (GBS) infection is passed on to the baby during delivery.

The GBS vaccine targeting sub-Saharan Africa will be administered to the pregnant mothers in the last trimester to protect the baby from the killer disease.

It is expected that the vaccine will be available for use in the next 10 years.

READ: Maternal deaths in East Africa worrying despite gains

It is estimated that one in four pregnant women in sub-Saharan Africa is a carrier of the GBS bacterium and babies who survive the illness are often left with life-long disabilities.

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“While GBS is harmless in most cases, it can lead to a range of serious illnesses within the first week of a baby’s life including septicaemia, pneumonia and meningitis,” said Biovac chief executive Morena Makhoana.

READ: Where mothers and infants survive by the grace of God

The laboratory work on the vaccine has begun. It will be developed in South Africa.

Support

“PATH will provide the technical assistance and advise on the vaccine development while Biovac will work on the vaccine,” said Dr Makhoana.
The Bill and Melinda Gates Foundation will provide $30 million for the project for five years.

The director for pneumonia at the Foundation, Keith Klugman, said that the funding will be extended if there are milestones to be achieved after the first results are released.

“We expect the initial results of the GBS vaccine to be over 80 per cent succesful,” said Dr Klugman.

According to Gichuhi Kamau, a gynaecologist at Kenyatta National Hospital in Nairobi, most health facilities in the country do not screen mothers for GBS.

“Screening is done in just a few private hospitals and only when a mother exhibits symptoms such as a rupture of membranes before 37 weeks of gestation, high fever during labour and urinary tract infection; the mother is then given antibiotics,” said Dr Kamau.

However, not every baby born to a mother who tests positive for GBS becomes ill.

READ: Post-partum contraceptive approved

Douglas Gaitho, a resident paediatrician in Nairobi said babies who contract GBS will show signs at birth such as excessive irritability/crying, refusal to breast feed, temperature instability, difficulty breathing, convulsions, feed intolerance and reduced urine output.

“If tests confirm the baby is infected, they are put on antibiotics,” said Dr Gaitho, adding that if untreated, GBS can cause severe illness like meningitis.”

High risk

Studies conducted in Kenya, South Africa and Malawi indicate that GBS is the leading cause of meningitis in newborns a week or less old.

About two per cent to three per cent of infants who develop GBS infection will die, though the risk of death is higher for premature babies born before 33 weeks.

The Kenya GBS study conducted in Kilifi found that GBS is an important cause of stillbirth and neonatal disease in the country. The incidence of stillbirth was comparable to early onset disease in hospital births in 2/1,000 births.

READ: Complications during birth raise risks of maternal, infant mortality in EA

Mark Alderson, who leads PATH’s vaccine development,  said that although GBS is also common in developed countries like the US and the UK, expectant women there are screened during their last weeks of pregnancy and those who test positive are given antibiotics.

But screening mothers at this stage is not always effective and safe, he said.

“A vaccine would significantly reduce the need for antibiotics in pregnant women during labour and in infants who contract a group B strep infection, which also means removing one more contribution to antibiotic resistance concerns,” said Dr Anderson.

READ: EDITORIAL: We still have more ground to cover in maternal healthcare

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