Reducing neonatal deaths and stillbirths is an international public health priority, yet the contribution of maternal infection, potentially amenable to intervention, is unclear, with essentially no data from the highest mortality settings. We propose to provide a robust description of the association of maternal infection with stillbirths and early neonatal deaths, by studying mothers delivering in Kilifi, Kenya, and in Harar, Ethiopia.
We will retrospectively investigate mothers in Kilifi County Hospital, Kenya, from a well-characterized existing maternal cohort (2011-16) in a case-control design (cases=350, controls=500). Laboratory investigation using nucleic acid detection (multiple uniplex PCR) from stored blood samples will be done at KEMRI-Wellcome Trust Research Programme laboratories. In Ethiopia, we will do a prospective study in Hiwot Fana Hospital, Harar, where we will recruit and investigate mothers (2017-20) in the same case-control design (cases=350, controls=500). Laboratory investigation at the College of Health Sciences, Haramaya University, will include both conventional (culture) and nucleic acid detection methods (multiple uniplex PCR).
We expect to provide important data on the contribution of maternal infection to stillbirth and early neonatal death in East Africa. This will identify those infection which it is most important to reduce and thus direct public health interventions.