This week PLOS Medicine publishes the following new articles:
Conducting a systematic review and meta-analysis, Grace Chan and colleagues report that early-onset neonatal infection (the cause of a significant proportion of deaths in the first week of life) is associated with maternal infection and colonization during the intrapartum period. The study implies that the risk of early neonatal infection among women with maternal infections is high and presumably even higher in low-resource settings where most women deliver at home without access to health care. Intrapartum antibiotic prophylaxis could reduce the incidence of maternally acquired early-onset neonatal infections; development of a simple algorithm that combines clinical signs and risk factors to diagnose maternal infections would be useful in settings where lab facilities are not available.
Mental health conditions contribute to approximately 14% of the total global burden of disease but there is a substantial treatment gap in both developed and developing countries. Treatment of mental health conditions in low resource settings such as Nigeria, one of Africa’s most populous countries, is particularly challenging where there are few mental health professionals. In order to address the treatment gap the World Health Organization (WHO) has developed a manual, known as the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG), which is designed to help scale up the coverage of mental health services in low resource settings by providing guidance for non-specialists to provide mental health services. Ove Gureje and colleagues describe their experience of contextualizing and adapting the WHO’s mhGAP-IG for Nigeria. Details on this ongoing series on Global Mental Health Practice can be found in the Editorial Putting Evidence into Practice: The PLOS Medicine Series on Global Mental Health Practice.
In a double-blind randomized placebo-controlled trial, Sophie Boisson and colleagues evaluate the effect of household water treatment in preventing diarrheal illnesses in children under five years of age in Orissa, a state in southeast India. The results provide no evidence that the intervention was protective against diarrhea and raise additional questions about the actual health impact of household water treatment under these conditions.