‘Urgent’ need for Strep B vaccine to prevent baby deaths

The World Health Organization (WHO) has called for urgent development of vaccines against Group B streptococcus, also known as GBS or Strep B, as new figures reveal that the bacterium is responsible for 150,000 deaths ofbabies每年全球。

世界卫生组织的报告,伦敦政治经济学院(Hygiene and Tropical Medicine (LSHTM) says the bacterium, which is harmless for most pregnant women who carry it, is linked to 46,000 stillbirths annually and more than half a million preterm deliveries. It can also cause long-term disability.

据世卫组织报道，目前正在开发几名疫苗候选人，但尽管有数十年的途径，但仍未开发。

报告显示，“发展中国家承担着链球菌B的最高负担，每年杀死近20万名婴儿。”

Joachim Osur, Vice Chancellor, Amref International University, Nairobi

Healthexperts say a maternal vaccine against GBS could be highly cost-effective and benefit all regions of the world, particularly low- and middle-income countries (LMICs) where the vast majority of cases occur.

“这项新的研究首次量化了GB对术前出生以及神经系统障碍的主要贡献，例如脑瘫，听力和视力丧失，这可能会在GBS相关感染后发生，”医疗菲利普·兰巴赫（Philipp Lambach）说。”officer with the WHO’s vaccines and biologicals department who co-authored the study.

他说，这项研究表明，链球菌B是对新生儿生存和福祉的重大且无可意识的威胁，对全世界的家庭具有毁灭性的影响。

研究表明，LMIC尤其受到打击，占案件的98％。

Joy Lawn, directorof the Maternal Adolescent Reproductive and Child Health (MARCH) Centre at LSHTM and a contributor to the report, said: “Sub-Saharan Africa has a disproportionate burden, since Africa has 13 per cent of the world’s population and almost five per cent of burden of GBS deaths for newborns and stillbirths.”

Lawn认为，更令人担忧的是，卫生专业人员通常在任何情况下，无论何时何地都会错过GBS案件。她解释说：“世界上大多数助产士都会看到案件，但可能不知道是否没有接受调查。”

据内罗毕AMREF国际大学生殖健康专家兼副校长Joachim Osur称，在非洲，这个问题可能比数字所建议的更为明显。

“非洲的问题是，由于卫生系统薄弱，我们没有调查宫内或胎儿死亡的原因。因此，我们不知道原因。” Osur解释说。

“This bacterium could be causing many deaths in our communities. The sooner we can get the vaccine, the better.”

该报告称，全球所有孕妇中平均有15％的妇女（几乎每年的2亿孕妇）在其阴道中通常没有症状。它可以在出生期间或生命早期在子宫中传递给婴儿。

Currently antibiotic treatment given to women during labour are the main means of preventing GBS diseases in newborn infants, the study says.

If the bacterium is detected during pregnancy, however, even in regions with high treatment coverage, there remain significant risks as this intervention is unlikely to prevent most GBS associated stillbirths, preterm births or GBS diseases that occur later after birth, it adds.

According to Martina Lukong Baye, coordinator of a national programme to combat maternal, newborn and child mortality at the Ministry of Health in Cameroon, a new maternal vaccine against GBS would be a game-changer in the reduction of newborn and maternal deaths for the most affected countries, especially in Sub-Saharan Africa.

Several vaccines are at phase two clinical trials, said Lambach, adding: “Some of them are multivalent, covering most of the major strains of GBS in pregnant women.”

但是他补充说，疫苗开发是复杂且昂贵的，尤其是在晚期临床试验中，由于证据差距而存在不确定性。

关于疾病严重程度以及在低资源环境中实施的可行性的假设也可能导致制造商优先考虑GBS疫苗的开发。

“The evidence and analysis in the report aim to help assure manufactures, [by] indicating that the disease burden is greater than previously assumed,” Lambach added. “And by suggesting that an affordably-priced vaccine is likely to be cost-effective, have a positive global net monetary benefit … and likely be financially sustainable and profitable if adopted in low-, middle-, and high-income countries.”

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