Sub-Saharan Africa faces the highest burden of perinatal deaths globally, with nearly half of all stillbirths and early neonatal deaths (death within the first 72 hours) occurring in this region. A recent study, PregnAnZI-2, found that over 80% of neonatal deaths occurred in this early period, with a neonatal mortality rate of 17 per 1,000 births. The study identified intrapartum-related asphyxia (IRA) as the leading cause of both mortality and long-term neurological disabilities. Infection contributes the largest proportion of perinatal deaths. High-quality data on the main pathogens responsible for these deaths is necessary for guiding investment and prioritization for vaccine development. Given the ongoing efforts to develop GBS, E. coli and K. pneumoniae vaccines, a more complete understanding of their contribution to neonatal morbidity and mortality across sub-Saharan regions is urgently needed.

The study will use a nested case-control design within the PRECISE cohort and aims to address these gaps by investigating the contribution of Group B Streptococcus (GBS), Escherichia coli, and Klebsiella pneumoniae to morbidity (IRA) and mortality (stillbirth and deaths within 72 hours) in Kenya, the Gambia and Mozambique.

By including IRA alongside perinatal deaths, and using appropriate controls, this study aims to generate more comprehensive data on the pathogens’ impact on both morbidity and mortality.

GBS-A and REKAP projects are funded by the Gates Foundation

Project Lead: Prof Anna Roca (IS Global)

Co-Investigators Peter von Dadelszen (KCL), Esperanca Sevene (UEM), Abdul Sesay (MRC-Gambia), Angela Koech (AKU), Patricia Okiro (AKU), Bakary Sangyang (MRC-Gambia)

Project Staff: Sambou Suso (MCR-G), Binta Faye (MRC-G), Stanley Onyango (AKU), Jospeh Mutunga (AKU), Alice Kanyua (AKU), Anifa Vala (UEM), Alice Manjate (UEM)

Project Management: Maria Climent (IS Global), Marie-Laure Volvert (KCL)