PLoS medicine
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Tom Boyles reflects on differing approaches taken for treating patients with Ebola virus disease in low- and high-resource settings.
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Historical Article
Ebola Virus Disease: Experience and Decision Making for the First Patients outside of Africa.
David Stephens and colleagues describe their experience of treating patients with Ebola virus disease at Emory University in the United States.
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The importance of maternal sanitation behaviour during pregnancy for birth outcomes remains unclear. Poor sanitation practices can promote infection and induce stress during pregnancy and may contribute to adverse pregnancy outcomes (APOs). We aimed to assess whether poor sanitation practices were associated with increased risk of APOs such as preterm birth and low birth weight in a population-based study in rural India. ⋯ This study provides the first evidence, to our knowledge, that poor sanitation is associated with a higher risk of APOs. Additional studies are required to elucidate the socio-behavioural and/or biological basis of this association so that appropriate targeted interventions might be designed to support improved birth outcomes in vulnerable populations. While it is intuitive to expect that caste and poverty are associated with poor sanitation practice driving APOs, and we cannot rule out additional confounders, our results demonstrate that the association of poor sanitation practices (open defecation) with these outcomes is independent of poverty. Our results support the need to assess the mechanisms, both biological and behavioural, by which limited access to improved sanitation leads to APOs.
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Jayne Tierney and colleagues offer guidance on how to spot a well-designed and well-conducted individual participant data meta-analysis.
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Courtney Lyles and colleagues highlight how the expansion of patient-facing electronic health record portals could exacerbate existing healthcare disparities.