Emotional and Behavioral Outcomes in Childhood for Survivors of Invasive Group B Streptococcus Disease in Infancy: Findings From 5 Low- and Middle-Income Countries

Jaya Chandna, Wan Hsin Liu, Ziyaad Dangor, Shannon Leahy, Santhanam Sridhar, Hima B. John, Humberto Mucasse, Quique Bassat, Azucena Bardaji, Amina Abubakar, Carophine Nasambu, Charles R. Newton, Clara Sánchez Yanotti, Romina Libster, Kate Milner, Proma Paul, Joy E. Lawn, Shabir A. Madhi, Z. Dz, S. LaLois Harden, Azra Ghoor, Sibongile Mbatha, Sarah Lowick, Tamara Jaye, Sanjay G. Lala, Pamela Sithole, Jacqueline Msayi, Ntombifuthi Kumalo, Tshepiso Nompumelelo Msibi, S. Sa, H. B. Ja, Asha Arumugam, Nandhini Murugesan, Nandhini Rajendraprasad, Mohana Priya, A. Aa, C. Nc, Adam Mabrouk Adan, Patrick Vidzo Katana, Eva Mwangome, C. Nr, Q. Ba, Azucena Bardají, Justina Bramugy, H. Ma, Sergio Massora, R. Lr, C. Ys, Valeria Medina, Andrea Rojas, Daniel Amado, Conrado J. Llapur, K. Ma

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background: Survivors of invasive group B Streptococcus (iGBS) disease, notably meningitis, are at increased risk of neurodevelopmental impairment. However, the limited studies to date have a median follow-up to 18 months and have mainly focused on moderate or severe neurodevelopmental impairment, with no previous studies on emotional-behavioral problems among iGBS survivors. Methods: In this multicountry, matched cohort study, we included children aged 18 months to 17 years with infant iGBS sepsis and meningitis from health demographic surveillance systems, or hospital records in Argentina, India, Kenya, Mozambique, and South Africa. Children without an iGBS history were matched to iGBS survivors for sex and age. Our primary outcomes were emotional-behavioral problems and psychopathological conditions as measured with the Child Behavior Checklist (CBCL). The CBCL was completed by the child's primary caregiver. Results: Between October 2019 and April 2021, 573 children (mean age, 7.18 years) were assessed, including 156 iGBS survivors and 417 non-iGBS comparison children. On average, we observed more total problems and more anxiety, attention, and conduct problems for school-aged iGBS survivors compared with the non-iGBS group. No differences were found in the proportion of clinically significant psychopathological conditions defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Conclusions: Our findings suggested that school-aged iGBS survivors experienced increased mild emotional behavioral problems that may affect children and families. At-risk neonates including iGBS survivors need long-term follow-up with integrated emotional-behavioral assessments and appropriate care. Scale-up will require simplified assessments that are free and culturally adapted.

Original languageEnglish
Pages (from-to)S35-S43
JournalClinical Infectious Diseases
Publication statusPublished - 15 Jan 2022


  • Group B Strep
  • emotional behavior
  • neonatal sepsis
  • neurodevelopment


Dive into the research topics of 'Emotional and Behavioral Outcomes in Childhood for Survivors of Invasive Group B Streptococcus Disease in Infancy: Findings From 5 Low- and Middle-Income Countries'. Together they form a unique fingerprint.

Cite this