The Health and Economic Impacts of Group B Streptococcus Disease Among Infants in Ontario, Canada
Notice bibliographique
Résumé
Group B Streptococcus (GBS) remains a leading cause of neonatal morbidity and mortality worldwide, despite preventive measures such as intrapartum antibiotic prophylaxis (IAP). Globally, an estimated 20 million pregnant individuals are colonized with GBS each year, leading to nearly 400,000 cases of infant GBS disease and over 90,000 infant deaths annually. While routine screening using rectovaginal swabs in the late third trimester and IAP have reduced the incidence of early-onset GBS disease (infection occurring within the first 6 days of life) in high-income countries like Canada, current strategies have important limitations: they are less effective against later-onset GBS disease (beyond the first week of life), may miss cases due to false-negative screening results or changes in maternal colonization status, and have limited impact on GBS-associated preterm births and stillbirths. Moreover, despite the widespread adoption of these prevention strategies in Canada, studies evaluating their effectiveness remain sparse, often relying on outdated or regionally limited data with small sample sizes. Important gaps also exist in fully understanding the true burden of GBS disease, its long-term neurodevelopmental consequences, and its broader economic impact. As maternal immunization with a GBS vaccine is being explored as a potential future prevention strategy, robust epidemiological and health economic data are critically needed to support vaccine development, inform policy decisions, and guide future implementation efforts. This dissertation aimed to address these gaps by evaluating the epidemiological, clinical, and economic burden of infant GBS disease in Ontario, Canada. Leveraging real-world, population-wide health administrative and registry data, this research pursued three key objectives: (1) to estimate the burden of infant GBS disease, describe epidemiological trends, and assess the effectiveness of current prevention strategies; (2) to evaluate the risk of neurodevelopmental impairments (NDIs) in early childhood following infant GBS disease, while examining sex and prematurity as effect modifiers; and (3) to determine the healthcare costs associated with GBS disease in infancy. The findings from this dissertation highlight the substantial health and economic burden of infant GBS disease in Ontario and reveal ongoing challenges with current prevention efforts. In the first study, despite demonstrating high maternal screening coverage, we identified missed opportunities for IAP administration, and the incidence of later-onset disease remained unchanged across the five-year study period. The second study found that survivors of infant GBS disease had approximately twice the risk of developing neurodevelopmental impairments by five years of age, with particularly elevated risks among preterm infants and males. The last study demonstrated that infant GBS disease was associated with substantial short-term healthcare costs, particularly during the first 30 days after disease onset. Collectively, these findings can support clinical and public health planning, inform cost-effectiveness analyses, and contribute to evidence-based policy development as Canada and other jurisdictions explore the potential introduction of maternal GBS vaccination in the future, should a vaccine become available, licensed, and recommended for use.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».