A grant from the McClay Foundation will enable Queen's researchers to work with clinicians to offer fast diagnostic testing to prevent meningitis and sepsis in maternity wards for the first time in Malawi.
Maternal health is a huge issue in developing countries where 99 per cent of all maternal and neonatal deaths occur. The neonatal mortality rate is also much higher in Africa, at four times higher than that of developed regions.
Women and babies die as a result of complications during, and following, pregnancy and childbirth, including infection.
Queen's University Belfast in collaboration with HiberGene Diagnostics and Belfast Health & Social Care Trust have developed an innovative rapid test for GBS using LAMP (Loop-mediated isothermal AMPlification) technology. The HiberGene test can identify GBS with very high accuracy within one hour, so it can be used during labor - a strategy called intrapartum testing.
Intrapartum is considered the most accurate time to test as it prevents unnecessary antibiotic use or missed GBS infections. The test is also simple enough to use as a "near patient" test, in a small lab or room next to a ward, without the need for extensive laboratory training. Queen's researchers will work with trained clinicians in a number of maternity wards in Malawi, to use the LAMP test.
Principal Investigator Professor Mike Shields from the Wellcome-Wolfson Institute for Experimental Medicine at Queen's University Belfast explains:
In developing countries, where access to laboratory testing is sparse, these tests could have a huge positive impact on the health of mothers and their babies. Detecting the GBS within the hour will mean that GBS positive women can be identified and given antibiotics to prevent transmission of GBS during delivery that could lead to serious infections including meningitis, sepsis and death."
Around 25 per cent of pregnant women are colonized with the bacterium Group B Streptococcus (GBS). The majority of pregnant women who carry this bacterium will never be aware. However, it can be fatal in instances when it is passed to babies during childbirth.
Although this is extremely rare in the developed world, in developing countries where there are many risk factors including inadequate services, distance and poverty, the prevalence of serious GBS infection to new-borns is much higher.
GBS can be difficult to detect as the mother who carries the bacteria often shows no symptoms. In many developed countries, testing for GBS in pregnancy is carried out two to four weeks before delivery, to enable GBS positive women to be given antibiotics to prevent transmission of the infection to the baby during childbirth. The turnaround for current tests is 48 hours, which means testing during labor is not feasible.
In the developing world, testing that requires a laboratory can be prohibitively expensive and very difficult to access in practical terms, particularly in rural settings. In reality, conventional testing for GBS is not available in most developing countries, meaning proven strategies to prevent GBS transmission cannot be used.
The McClay Foundation has supported this project enabling clinicians in the developing world to detect this life-threatening pathogen within an hour at a maternity ward using the HiberGene GBS test.