Urgent prevention strategies of burns and evidence-based practice with early nutritional supplementation are needed to reduce high rates of malnutrition and mortality.

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Preservation of viable tissue is important in wound management. It is achieved by small, incremental removal of devitalised, necrotic and infected tissues. Maggot debridement therapy (MDT) is used in septic necrotic wounds that fail to respond to conventional modalities. MDT has relied on Lucilia sericata, which consumes only necrotic tissues, as opposed to Lucilia cuprina, which devours both flesh and necrotic tissues. Recent findings have shown that L. cuprina consumes mainly necrotic and very small amounts of viable tissues and may be used in MDT where L. sericata is very rare or absent. Here we describe wound healing in a patient from rural South Africa with cutaneous myiasis. Our findings agree with workers who indicated that L. cuprina could be used in MDT.

One obstacle to contain the HIV-1 epidemic in the general population in Africa is a lack of knowledge about how it is spread in rural areas. We examined 683 pregnant women in 1989 and 484 in 1993 who attended antenatal clinics in Lindi district, Tanzania to determine changes in the prevalence of HIV-1 in a remote area in East Africa. The prevalence rose from 0.44% in 1989 to 8.7% in 1993. Women with more than 1 partner (17.25% vs 2.78%), STD patients (42.4% vs 6.2%), women from urban areas (10.2% vs 3.57%) and patients younger than 21 years were more likely to have HIV antibodies. By logistic regression analysis, 1993 as year of testing was associated with the greatest risk for HIV seropositivity (P < 0.00002) followed by clinical signs of STD (P < 0.00005) and urban residence (P = 0.0275). Teaching of all women attending antenatal care how to minimize their future risk of acquiring HIV is urgently needed as one tool to prevent a fast spread of HIV throughout the continent.