Health-care-associated infections in developing countries.

Health-care-associated infections in developing countries are a serious issue that is scarcely addressed in the scientifi c literature. Hence, the systematic review and meta-analysis in The Lancet by Benedetta Allegranzi and colleagues from WHO, which assessed the epidemiology of health-care-associated infections, is impressive. In this study, the investigators analysed pooled data from 220 selected publications from 1995 to 2008, including data from the Americas (22%), Europe (20%), southeast Asia (16%), the eastern Mediterranean (8%), Africa (5%), and other regions (29%). The prevalence of health-care-associated infections in developing pre-eclampsia and eclampsia. Studies have been done on calcium supplementation and low-dose aspirin as preventive measures in pregnancy, but evidence on eff ectiveness and on which interventions can be delivered at various levels of the health system is not always clear. The Collaborative E trial (Magpie) provided evidence that magnesium sulphate should be the treatment of choice for preventing eclamptic seizures or their recurrence, and should be used in preference to diazepam, phenytoin, and a lytic cocktail. The Magpie trial also showed that magnesium sulphate halves eclampsia risk after pre-eclampsia, and probably reduces the risk of maternal death. In addition to the limitations noted by the investigators, it is important to recognise that the PIERS prediction is only useful if the health system and the community in which the woman lives have appropriate and suffi cient transportation and referral systems, and the capacity to administer drugs (magnesium sulphate, antihypertensive drugs), induce labour, and provide post partum care. We urge the maternal and neonatal health community to consider the study in the context of the large continuum of interventions that need to be in place. Recently, synergies and connections between the maternal and neonatal health fi elds have been emphasised. Hypertension in pregnancy and pre-eclampsia challenge the public health community because of the need to simultaneously protect the mother and baby, and to balance sometimes competing needs to bring forward or delay the end of the pregnancy. This study focuses mainly on maternal outcomes but also has implications for neonatal health. Hypertension in pregnancy and pre-eclampsia are conditions that call for further collaboration between maternal and neonatal health experts. We applaud von Dadelszen and colleagues in their eff orts to validate the fullPIERS model and thereby advance future treatments and interventions. We hope that this new knowledge will be translated into eff ective and immediate action and further adapted and validated for use in low-income and middle-income countries, and thus used to its greatest advantage to save the lives of mothers and babies.