Background: Africa is in an orphan-care crisis. In Zimbabwe, where one-fourth of adults are HIVpositive and one-fifth of children are orphans, AIDS and economic decline are straining society's ability to care for orphans within their extended families. Lack of stable care is putting thousands of children at heightened risk of malnourishment, emotional underdevelopment, illiteracy, poverty, sexual exploitation, and HIV infection, endangering the future health of the society they are expected to sustain.

Few programmes for sub-Saharan Africa's 12.3 million children orphaned by AIDS have focused on their high risk for psychosocial problems. As groundwork for supporting orphans' healthy development, this study describes the preparation, grief, and memorial experiences and the physical and psychosocial well-being of 144 double orphans and 109 single orphans in rural eastern Zimbabwe. Most received no preparation or orphan-specific support for mourning and emotional recovery. On measures of physical and psychosocial well-being, orphans did more poorly than 87 non-orphaned classmates, perhaps reflecting the combined interaction of economic disadvantage and orphan status. Financial hardship was most severe among single orphans. Double orphans' responses suggested perceptions of isolation, lack of support and personal difference. Distress was greatest among younger orphans (<13 years). Given the importance of emotional health to child and societal development, scaled-up financial assistance should incorporate programmes to help children prepare for and recover from the loss of their parents.

The Mycotrim Triphasic flask system (Irvine Scientific, Irvine, Calif.) was compared with a system composed of Mycotrim GU broth (Irvine Scientific) and A7 or A8 agar (Remel, Lenexa, Kans.) for the ability to detect Ureapla*ma urealyticum and Mycoplasma hominis from 129 genital specimens. Of the 64 specimens positive for U. urealyticum, 25, 98, and 100%o were detected on Mycotrim Triphasic agar and A7 and A8 agars, respectively. All 18 specimens that grew M. hominis were detected by A7 and A8 agars, and 94% grew on Mycotrim Triphasic agar. Mycotrim GU broth detected all of the positive specimens, and Mycotrim Triphasic broth detected all but one. Mycotrim GU broth inoculated simultaneously with either A7 or A8 agar was found to be more sensitive and cost-effective than the Mycotrim Triphasic flask system.

Collagenous gastritis has been reported as a rare cause of nausea, diarrhea, weight changes, and early satiety in female patients. Here, we describe two women aged 43 and 71 years who presented with similar symptoms. Gastric biopsies from both individuals showed thickened, irregular subepithelial collagen bands (>10 μm). The pathogenesis of collagenous gastritis is poorly understood, but it may be the presenting symptom for many underlying autoimmune conditions. In particular, there is a well-established connection between collagenous disorders of the gastrointestinal tract and celiac sprue, Sjögren syndrome, and lymphocytic colitis; however, none of these conditions had been diagnosed in our patients. The older woman had incidentally discovered hypogammaglobinemia and IgA deficiency, whereas the younger woman suffered from fibromyalgia. Although a gluten-free diet and budesonide have been effective in some cases, there is no standardized therapy for collagenous gastritis. Our patients trialed diet modification and have required no additional medical interventions.

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