Enrolment and programmatic trends and predictors of antiretroviral therapy initiation from president's emergency plan for AIDS Relief (PEPFAR)-supported public HIV care and treatment sites in rural Mozambique.

Many countries in sub-Saharan Africa have made antiretroviral therapy (ART) available in urban settings, but the progress of treatment expansion into rural Africa has been slower. We analysed routine data for patients enrolled in a rural HIV treatment programme in Zambézia Province, Mozambique (1 June 2006 through 30 March 2009). There were 12,218 patients who were ≥15 years old enrolled (69% women). Median age was 25 years for women and 31 years for men. Older age and higher level of education were strongly predictive of ART initiation (P < 0.001). Patients with a CD4+ count of 350 cells/µL versus 50 cells/µL were less likely to begin ART (odds ratio [OR]: 0.19, 95% confidence interval [CI]: 0.16-0.23). In rural sub-Saharan Africa, HIV testing, linkage to care, logistics for ART initiation and fears among some patients to take ART require specialized planning to maximize successes. Sustainability will require improved health manpower, infrastructure, stable funding, continuous drug supplies, patient record systems and, most importantly, community engagement.

Surveillance and epidemiology of occupational pesticide poisonings on banana plantations in Costa Rica.

A review of one year's workers' compensation records from the Costa Rican National Insurance Institute was performed in a banana plantation region to determine rates of and risk factors for agrichemical poisonings. Review of 9,060 medical records revealed that the most commonly reported agrichemical-related injuries (n=800) were chemical burns (28%) and acute intoxications (21%). Other agrichemical-related injuries included eye injuries, chemical dermatoses, and chronic fungal infections. The incidences and types of injuries differed between male and female workers and workers of different age groups. Older female workers were more likely to report chemical dermatoses. Young male workers were more likely to experience acute intoxication. These differences seem to be attributable to divisions of labor by gender and age among plantation workers.