We believe the limited scale of microbiology capacity in-country and its resulting undetected bacteremia to be an important contributor to the elevated prevalence of anemia in Mozambique and an important cause of preventable morbidity and mortality in Mozambican children with HIV.40 In addition, other studies in Mozambique have shown that although not common, disorders of Hb production do exist. This evidence concerns the gene GSTM1 and bacterial infectious disease with sepsis.