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A multi-country cross-sectional study of vaginal carriage of group B streptococci (GBS) and Escherichia coli in resource-poor settings: prevalences and risk factors

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dc.contributor.author Cools, P.
dc.contributor.author Jespers, V.
dc.contributor.author Hardy, L.
dc.contributor.author Crucitti, T.
dc.contributor.author Delany-Moretlwe, S.
dc.contributor.author Mwaura, M.
dc.contributor.author Ndayisaba, G. F.
dc.contributor.author van de Wijgert, J. H.
dc.contributor.author Vaneechoutte, M.
dc.date.accessioned 2016-05-18T13:24:52Z
dc.date.available 2016-05-18T13:24:52Z
dc.date.issued 2016
dc.identifier.issn 1932-6203
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0148052
dc.identifier.other ITG-H2B
dc.identifier.other ITG-H3B
dc.identifier.other ITG-C4A
dc.identifier.other MULTI
dc.identifier.other DPH
dc.identifier.other U-ECHIV
dc.identifier.other DCS
dc.identifier.other U-ARLAB
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other OAJ
dc.identifier.other Abstract
dc.identifier.other UPD61
dc.identifier.uri http://hdl.handle.net/10390/8810
dc.description.abstract BACKGROUND: One million neonates die each year in low- and middle-income countries because of neonatal sepsis; group B Streptococcus (GBS) and Escherichia coli are the leading causes. In sub-Saharan Africa, epidemiological data on vaginal GBS and E. coli carriage, a prerequisite for GBS and E. coli neonatal sepsis, respectively, are scarce but necessary to design and implement prevention strategies. Therefore, we assessed vaginal GBS and E. coli carriage rates and risk factors and the GBS serotype distribution in three sub-Saharan countries. METHODS: A total of 430 women from Kenya, Rwanda and South Africa were studied cross-sectionally. Vaginal carriage of GBS and E. coli, and GBS serotype were assessed using molecular techniques. Risk factors for carriage were identified using multivariable logistic regression analysis. RESULTS: Vaginal carriage rates in reference groups from Kenya and South Africa were 20.2% (95% CI, 13.7-28.7%) and 23.1% (95% CI, 16.2-31.9%), respectively for GBS; and 25.0% (95% CI, 17.8-33.9%) and 27.1% (95% CI, 19.6-36.2%), respectively for E. coli. GBS serotypes Ia (36.8%), V (26.3%) and III (14.0%) were most prevalent. Factors independently associated with GBS and E. coli carriage were Candida albicans, an intermediate vaginal microbiome, bacterial vaginosis, recent vaginal intercourse, vaginal washing, cervical ectopy and working as a sex worker. GBS and E. coli carriage were positively associated. CONCLUSIONS: Reduced vaginal GBS carriage rates might be accomplished by advocating behavioral changes such as abstinence from sexual intercourse and by avoidance of vaginal washing during late pregnancy. It might be advisable to explore the inclusion of vaginal carriage of C. albicans, GBS, E. coli and of the presence of cervical ectopy in a risk- and/or screening-based administration of antibiotic prophylaxis. Current phase II GBS vaccines (a trivalent vaccine targeting serotypes Ia, Ib, and III, and a conjugate vaccine targeting serotype III) would not protect the majority of women against carriage in our study population. en_US
dc.language English en_US
dc.subject Bacterial diseases en_US
dc.subject Streptococcus en_US
dc.subject Escherichia coli en_US
dc.subject Neonatal en_US
dc.subject Sepsis en_US
dc.subject Women en_US
dc.subject Vagina en_US
dc.subject Prevalence en_US
dc.subject Risk factors en_US
dc.subject Distribution en_US
dc.subject Microbiome en_US
dc.subject Vaginosis en_US
dc.subject Sexual practice en_US
dc.subject Prostitution en_US
dc.subject Control strategies en_US
dc.subject Sexual behavior en_US
dc.subject Behavior change en_US
dc.subject Kenya en_US
dc.subject Africa, East en_US
dc.subject Rwanda en_US
dc.subject Africa, Central en_US
dc.subject South Africa en_US
dc.subject Africa, Southern en_US
dc.title A multi-country cross-sectional study of vaginal carriage of group B streptococci (GBS) and Escherichia coli in resource-poor settings: prevalences and risk factors en_US
dc.type Article-E en_US
dc.citation.issue 1 en_US
dc.citation.jtitle PLoS ONE en_US
dc.citation.volume 11 en_US
dc.citation.pages e0148052 en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/26811897
dc.citation.jabbreviation PLoS ONE en_US


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