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Cited by 174Neonatal and Maternal InfectionsGlobal Maternal and Child HealthSepsis Diagnosis and Treatment

Maternal and early onset neonatal bacterial sepsis: burden and strategies for prevention in sub-Saharan Africa

Open access
Seale, Anna C, Mwaniki, Michael, Newton, Charles RJC, Berkley, James A·2009·The Lancet Infectious Diseases
DOI 10.1016/s1473-3099(09)70172-0PMC PMC2856817
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Abstract

Maternal and child health are high priorities for international development. Through a Review of published work, we show substantial gaps in current knowledge on incidence (cases per live births), aetiology, and risk factors for both maternal and early onset neonatal bacterial sepsis in sub-Saharan Africa. Although existing published data suggest that sepsis causes about 10% of all maternal deaths and 26% of neonatal deaths, these are likely to be considerable underestimates because of methodological limitations. Successful intervention strategies in resource-rich settings and early studies in sub-Saharan Africa suggest that the burden of maternal and early onset neonatal bacterial sepsis could be reduced through simple interventions, including antiseptic and antibiotic treatment. An effective way to expedite evidence to guide interventions and determine the incidence, aetiology, and risk factors for sepsis in sub-Saharan Africa would be through a multiarmed factorial intervention trial aimed at reducing both maternal and early onset neonatal bacterial sepsis in sub-Saharan Africa.

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Crossref · 10.1016/s1473-3099(09)70172-0

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  • In low-resource settings, differences in antibiotic prophylaxis and treatment, cesarean delivery practices, HIV prevalence, access to microbiology testing, antimicrobial stewardship and infection control practices may lead to differences in infection incidence, microbiology, and antimicrobial resistance.

    “In low-resource settings, differences in antibiotic prophylaxis and treatment, cesarean delivery practices, human immunodeficiency virus (HIV) prevalence, access to microbiology testing, antimicrobial stewardship and infection control practices may lead to differences in infection incidence, microbiology, and antimicrobial resistance.[4, 5, 9, 10]”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [4]

    The Risk factors for maternal sepsis and Incidence sections link caesarean delivery, antibiotic prophylaxis, and clean delivery practices to sepsis risk or incidence; the Aetiology and Conclusions sections also describe how limited microbiology facilities affect what can be identified. The paper says the contribution of HIV prevalence to maternal sepsis is largely unknown, and the passages do not support the claim about antimicrobial stewardship or differences in antimicrobial resistance. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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  • Prospective studies on the incidence, microbiology and antimicrobial resistance of postpartum infections are lacking.

    “prospective studies on incidence, microbiology and antimicrobial resistance are lacking.”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [4]

    The Incidence of maternal sepsis section says most sub-Saharan African estimates come from retrospective studies without microbiological investigation, while the Aetiology section says microbiological data are few. This supports a shortage of prospective incidence and microbiology studies in that setting, although the paper does describe one prospective study. The passages do not establish a corresponding shortage of studies on antimicrobial resistance. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • UTI microbiology and antimicrobial resistance in sub-Saharan Africa is not well described.

    “Though UTI microbiology and antimicrobial resistance in sub-Saharan Africa is not well described,[4, 5, 25]”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [4]

    The Risk factors for early onset neonatal sepsis section says mothers with a history of urinary tract infections are seldom identified in sub-Saharan Africa, probably because bacterial cultures were not done. This lends limited support to a gap in UTI microbiological data, but the paper does not establish the broader claim about UTI microbiology or address UTI antimicrobial resistance. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

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Authors
Seale, A. C., Mwaniki, M., Newton, C. R., & Berkley, J. A.
Affiliations
Kenya Medical Research Institute (KE)
Corresponding author
Seale, Anna C
ORCID
Venue
The Lancet Infectious Diseases
Publisher
Elsevier BV
Published
2009-07
Volume
9
Issue
7
Pages
428-438
ISSN
1473-3099 (ISSN-L)
DOI
10.1016/s1473-3099(09)70172-0
PMC
PMC2856817
OpenAlex
W2041816876
Cited by
174
References
71
Citations by year
2026: 3 · 2025: 5 · 2024: 13 · 2023: 8 · 2022: 13 · 2021: 11 · 2020: 12 · 2019: 8 · 2018: 8 · 2017: 18 · 2016: 11 · 2015: 12 · 2014: 14 · 2013: 10 · 2012: 11
FWCI
1.22
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • Wellcome Trust (077092)
  • University of Oxford
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
early-onset neonatal sepsis, sub-Saharan Africa, sepsis incidence, risk factors, maternal mortality, neonatal mortality, sepsis prevention, antibiotic therapy, antiseptic treatment
MeSH terms
Adolescent, Adult, Female, Humans, Infant, Newborn, Infant, Newborn, Diseases, Pregnancy, Pregnancy Complications, Infectious, Risk Factors, Incidence, Africa South of the Sahara, Sepsis, Young Adult

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