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Background: The majority of global HIV infections in children under 10 years of age occur during pregnancy, delivery or breastfeeding, despite improved coverage of 'prevention of mother-to-child transmission' (PMTCT) guidelines to reduce vertical transmission. This article looks closer at one community-based peer mentorship programme [Mentor Mothers Zithulele (MMZ)] in the Eastern Cape, South Africa which aims to supplement the existing heavily burdened antenatal programmes and improve PMTCT care. Methods: Semi-structured interviews were undertaken with HIV-positive women participating in MMZ and women receiving standard PMTCT care without any intervention. A focus group discussion (FGD) was conducted with women working as Mentor mothers (MMs) for MMZ to explore their experience of the impact of peer mentoring on the rural communities they serve. Results: Six main themes were identified in the interviews with antenatal patients: (i) MMs were a key educational resource, (ii) MMs were important in promoting exclusive breastfeeding, (iii) encouraging early HIV testing during pregnancy and (iv) providing psychosocial support to patients in their homes, thereby reducing stigma and sense of alienation. Respondents requested (v) additional focus on HIV education. MMs can (vi) function as a link between patients and health-care providers, improving treatment adherence. During the FGD two themes emerged; MMs fill the gap between patients and health services, and MMZ should focus on HIV awareness and stigma reduction. Conclusion: Peer mentoring programmes can play an important role in reducing vertical HIV transmission in resource-limited, rural settings by providing participants with education, psychosocial support, and a continuum of care. [ABSTRACT FROM AUTHOR]

An analysis of skin prick reactions in 500 consecutive patients referred for investigation and management of asthma showed that 240 patients had multiple positive reactions. Of these patients 46% had positive reactions to Aspergillus and they differed from patients with multiple positive reactions excluding Aspergillus by having onset of asthma at a younger age and being more atopic. Precipitins to Aspergillus were present in the serum of twenty-six of seventy-one consecutive patients in whom these were looked for. Thirteen of the patients with positive precipitins had chest radiograph shadows compatible with allergic bronchopulmonary aspergillosis (ABPA) and in eight of these there was sufficient evidence to make a diagnosis of ABPA. These results were obtained in a region where ABPA had never been previously recognized and they highlight the importance of routine skin prick testing with Aspergillus antigen and of awareness of ABPA in making this diagnosis.