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Volume 17, Number 10—October 2011

Dispatch

Group B Streptococcus and HIV Infection in Pregnant Women, Malawi, 2008–2010

Katherine J. GrayComments to Author , George Kafulafula1, Mary Matemba, Mercy Kamdolozi, Gladys Membe, and Neil French

Author affiliations: College of Medicine, Blantyre, Malawi (K.J. Gray, G. Kafulafula, M. Kamdolozi, G. Membe); Karonga Prevention Study, Karonga, Malawi (M. Matemba, N. French); London School of Hygiene and Tropical Medicine, London, UK (N. French)

Main Article

Table 1

Comparison of variables, including age, CD4 counts, and reproductive and medical history, for HIV-negative and HIV-positive study participants, Malawi, 2008–2010*

Variable All study participants,
N = 1,857† HIV-positive participants,
n = 402/21.7% HIV-negative participants,
n = 1,454/78.3% p value
Mean age, y (SD) 25.2 (5.9) 26.7 (5.5) 24.8 (5.9) <0.001
No. (%) recruited during wet season (Nov–Mar)
1,057 (57.0)
234 (58.2)
820 (56.4)
0.57
Reproductive and medical history
Pregnancies, median no. (range) 1 (0–10) 2 (0–8) 1 (0–10) <0.001
Live births, median no. (range) 1 (0–10) 1 (0–7) 1 (0–10) <0.001
Previous neonatal death, no. (%) 45 (2.4) 11 (2.7) 34 (2.3) 0.65
Median time since LMP, days (range) 275 (98–371) 275 (145–371) 276 (98–370) 0.17
Unwell at labor ward attendance, no. (%) 114 (6.1) 33 (8.2) 81 (5.6) 0.05
Membranes ruptured >18 h before enrolled, no. (%) 52 (2.8) 12 (3.0) 40 (2.8) 0.79
Previous HIV test, no. (%) 1,664 (89.7) 368 (91.5) 1,296 (89.1) 0.16
Taking ART, no. (%) 83 (20.7)
Median duration of ART, mo (range) 4 (1–144)
Genital ulcer disease, no. (%) 46 (2.5) 32 (8.0) 14 (1.0) <0.001
Sexually transmitted disease, no. (%) 34 (1.8) 23 (5.7) 11 (0.8) <0.001
S-P use during last 4 wk of pregnancy, no. (%)
1,779 (96.0)
379 (94.3)
1,395 (96.9)
0.38
Examination and other findings
First stage of labor, no. (%) 1,298 (69.9) 279 (69.4) 1,019 (70.1) 0.79
Premature labor before 36 wk, no. (%) 270 (14.5) 71 (17.7) 199 (13.7) 0.04
Registered for PMTCT on labor ward, no. (%) 333 (82.8)‡
Mean birth weight (SD), kg 2.90 (0.54) 2.81 (0.58) 2.91 (0.52) <0.001
Delivery by cesarean section, no. (%) 383 (20.6) 76 (18.9) 307 (21.1) 0.33
Stillbirth, no. (%) 30 (1.6) 13 (3.2) 17 (1.2) 0.004
Multiple birth, no. (%)
50 (2.7)
10 (2.5)
40 (2.8)
0.77
Laboratory tests
Plasma sample for CD4 count, no. 383§
CD4 count, median (range) 370 (20–1595)
No. failed samples¶ 18 5 13
GBS isolated, no. (%)# 390 (21.2) 77 (19.4) 313 (21.5) 0.4
Serotype
1a 71 (18.2) 11 (14.3) 60 (19.2)
1b 24 (6.2) 1 (1.3) 23 (7.4)
2 40 (10.3) 9 (11.7) 31 (9.9)
3 152 (39.0) 32 (41.6) 120 (38.3)
4 1 (0.3) 0 1 (0.3)
5 93 (23.9) 23 (29.9) 70 (22.4)
6 (1 sample), 8 (2 samples) 3 (0.8) 0 3 (1.0)
Untypeable, no (%) 6 (1.5) 1 (1.3) 5 (1.6)

*LMP, last menstrual period; ART, antiretroviral treatment; –, not applicable; S-P, sulfadoxine-pyrimethamine; PMTCT, prevention of mother-to-child transmission care; GBS, group B streptococcus.
†Form for 1 participant was missing.
‡No. includes only participants confirmed as HIV-positive.
§15 failures, 4 samples not obtained.
¶Contamination of the selective broth in 9 cases and incubator failure in 9 cases.
#Failed samples excluded from denominator to derive percentage.

*LMP, last menstrual period; ART, antiretroviral treatment; –, not applicable; S-P, sulfadoxine-pyrimethamine; PMTCT, prevention of mother-to-child transmission care; GBS, group B streptococcus.
†Form for 1 participant was missing.
‡No. includes only participants confirmed as HIV-positive.
§15 failures, 4 samples not obtained.
¶Contamination of the selective broth in 9 cases and incubator failure in 9 cases.
#Failed samples excluded from denominator to derive percentage.

*LMP, last menstrual period; ART, antiretroviral treatment; –, not applicable; S-P, sulfadoxine-pyrimethamine; PMTCT, prevention of mother-to-child transmission care; GBS, group B streptococcus.
†Form for 1 participant was missing.
‡No. includes only participants confirmed as HIV-positive.
§15 failures, 4 samples not obtained.
¶Contamination of the selective broth in 9 cases and incubator failure in 9 cases.
#Failed samples excluded from denominator to derive percentage.

Main Article

1Deceased.

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