ABSTRACT
Key Clinical Message: In the acute phase of Ebola virus disease (EVD) premature neonatal survival is extremely rare. High mortality is related to prematurity, neonatal complications of Ebola, and precarious conditions of neonatal care in underresourced ETUs. This is a case of preterm neonatal survival in the setting of acute maternal EVD infection. Abstract: This case describes rare preterm newborn survival in the setting of an Ebola treatment unit in Eastern DRC. The neonate was born vaginally to an acutely ill 17-year-old mother who was vaccinated against Ebola virus after being identified as a contact of her father, who was a confirmed case and who did not survive his infection. This woman was admitted to an Ebola treatment unit at 32 weeks of gestation and given monoclonal antibody treatment. She gave birth vaginally, succumbing to postpartum hemorrhage 14 h after delivery. This child survived despite compounding vulnerabilities of preterm birth and maternal Ebola infection. Despite a negative test for EVD, the neonate was given a single dose of monoclonal antibody therapy in the first days of life. We believe maternal vaccination and neonatal monoclonal antibody treatment contributed to the child's survival. The circumstances surrounding neonatal survival in this extremely resource-limited context must be analyzed and disseminated in order to increase rates of neonatal and maternal survival in future outbreaks. Maternal and neonatal health are critical aspects of outbreak response that have been understudied and underreported leaving clinicians severely underresourced to provide life-saving care in outbreak settings. Pregnancy and childbirth do not stop in times of disease outbreak, adequate equipment and trained staff required for quality neonatal care must be considered in future outbreak responses.
ABSTRACT
INTRODUCTION: Maternal vaginal colonization by Streptococcus agalactiae (GBS) has an important impact on neonatal health but has not been studied in the Democratic Republic of Congo. The aim of this study was to determine its frequency and influencing factors. METHODOLOGY: Vaginal samples (n = 509) for bacteriological analysis were collected from women in Bukavu, eastern DR Congo, during their third trimester of pregnancy, along with information about age, education and socio-economic status, and medical and obstetric-gynecological history. RESULTS: The overall GBS colonization rate was 20%. Colonization was significantly associated with low education, history of urinary infection during the pregnancy, history of premature childbirth or abortion, and HIV-positive serology, but was not significantly associated with socio-economic level or parity. CONCLUSIONS: The GBS colonization rate is similar to that found elsewhere on the continent. Further studies, with follow-up of neonates of infected mothers and evaluation of prevention/treatment strategies, are needed.
