When cases of pediatric hydrocephalus soared in East Africa, with an estimated 4,000 annual cases in Uganda alone, doctors didn’t know why. Neither did mothers, who said their babies were born normally but a severe infection in the first weeks of life led to cerebrospinal fluid building up in their brains. The babies often died, even when they were able to see healthcare providers.
But last week, the cause of the pediatric hydrocephalus was revealed. After 16 years of research, Dr. Sarah Morton of Harvard Medical School and her colleagues published study results that identify a bacteria, the Paenibacillus thiaminolyticus, as the source of many Uganda infections. Their work appears in the journal The Lancet Microbe.
Their pathway to the discovery included challenges like Uganda’s limited power grid (making it hard to keep samples frozen for analysis) or the access to advanced gene sequencing technologies.
But by 2020, Dr. Steven Schiff of Yale University School of Medicine and his investigative team had confirmed the bacteria was in the infants’ brains. It had always been thought harmless, but the African strains had become more toxic and more lethal. Over the next three years, the team set out to discover where the bacteria was coming from and how it was related to the infections and hydrocephalus.
They learned that the bacteria thrived in wet regions, like the swamps along Lake Victoria or along the banks of Lake Kyoga. Cases also rose during the rainy season. That information is helping the researchers to identify risk and work to prevent cases.
They also discovered resistance to common antibiotics used to treat sepsis infections in newborns, which often preceded the condition. Now, they understand how to intervene, and have started to study similar infections in Kenya and other countries.
“After all we have learned, the last thing we want to be doing is trying to treat infants after they’ve been infected with these highly virulent bacteria,” said Schiff. “If we can nail down how it is getting into the infants, then we can develop public health policies that can prevent these infections.”
Image: Mbarara Regional Referral Hospital