Prevalence of group B streptococcus anogenital colonization and feasibility of an intrapartum screening and antibiotic prophylaxis protocol in Cameroon, Africa

Academic Article

Abstract

  • © 2019 International Federation of Gynecology and Obstetrics Objective: To evaluate group B streptococcus (GBS) colonization prevalence and feasibility of intrapartum GBS screening/antibiotic prophylaxis (IAP) in Cameroon, Africa. Methods: Prospective cohort in the Cameroon Baptist Convention Health Services network. Maternity providers collected anogenital swabs from consenting term women in labor for testing by a rapid GBS-polymerase chain reaction (PCR) system. Positive tests (GBS+) resulted in initiation of intravenous ampicillin until delivery. Primary outcomes were GBS prevalence and proportion of GBS+ women receiving ampicillin before delivery and more than 4 hours before delivery. Results: A total of 219 women were enrolled from January 10 to April 27, 2017. GBS prevalence was 12.3% (95% confidence interval [CI] 7.9–16.7) with GBS+ women more likely to reside in urban areas (19.6% vs 9.7%, P=0.004). Of 27 GBS+ women, 19 (70.4%) received ampicillin before delivery and 14 (51.9%) 4 hours or longer before delivery. A median two doses of ampicillin (interquartile range [IQR] 1–5) were given and started at a median of 105 minutes (IQR 90–155) after swab collection and 20 minutes (IQR 10–45) after GBS result. Of the 8 women who did not receive ampicillin, 7 (87.5%) delivered before test results. Conclusion: A GBS IAP protocol is feasible in Cameroon and should be evaluated for widespread implementation in Cameroon and other low-income countries to decrease GBS-related morbidity.
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    Author List

  • Subramaniam A; Blanchard CT; Ngek ESN; Mbah R; Welty E; Welty T; Dionne-Odom J; Sander M; Halle-Ekane G; Tita ATN
  • Start Page

  • 238
  • End Page

  • 243
  • Volume

  • 146
  • Issue

  • 2