Relapsing fever, a disappearing cause of fever and maternal death in Sengerema, Tanzania, east Africa

Objective: To study the incidence of tick borne relapsing fever (TBRF) during the last 50 years, once like malaria an endemic disease in Sengerema, Tanzania.Design: By analyzing the annual reports, focusing on the number of admissions, maternal deaths, blood smears of patients with fever for Borrelia.Setting: Sengerema district, Tanzania.Subject: Admissions in Sengerema Hospital due to TBRF.Main Outcome Measures: From 1960 to 2010, we analyzed the incidence of TBRF.Result: Forty annual admissions in the sixties/seventies, 200 in the eighties (range from 37 in 1964 to 455 in 1988), dropping to 30 in the nineties. For the last nine years no Borrelia spirochetes were found in blood smears at the laboratory anymore and no admissions for TBRF were  registered. The number of maternal deaths due to relapsing fever  decreased simultaneously; the last one recorded was in 2002.Conclusion: During the last century, we have witnessed the disappearing of tick borne relapsing fever in Sengerema. Increase of gold mining,  improved local economy, housing and standards of living after the nineties resulted in an almost complete eradication of the incidence of TBRF

Symptom attribution and presentation in general practice after an extreme life event

Background. A serious life event is likely to shape attributions relating to symptoms experienced afterwards. While they may play an important role in prognosis and seeking care, such perceptions have hardly been studied among survivors of a disaster. Objective. To investigate the association between self-reported health problems that have been attributed to an extreme life event and the symptoms presented to GPs. Methods. A two-wave longitudinal survey (2–3 weeks and 18 months) among survivors of a fireworks disaster was combined with a continuous morbidity surveillance in general practice. Symptoms attributed to the disaster reported in an open-ended question in the two waves were analysed using descriptive statistics. Differences in presented symptoms over time were analysed using logistic multilevel analysis. Results. More than half of the respondents reported health problems, which were, in their opinion, related to the disaster. Psychological problems were most frequently reported in association with the disaster, and in contrast to physical attributed symptoms, presentation of these problems in general practice decreased over time. In the total sample, musculoskeletal symptoms were less frequently presented in the longer term. Survivors who attributed symptoms to the disaster at both waves or after 18 months only most often presented such symptoms to the GP. Conclusion. Survivors attributed psychological problems and physical symptoms to the disaster at short-term and midterm post-disaster. Most of these survivors presented such symptoms to the GP. Attribution of symptoms to an extreme life event such as a disaster may therefore require special attention from the GP. (aut. ref

Form removal aspects on the waviness parameters for steel sheet in automotive applications : fourier filtering versus polynomial regression

Premium car makers attach great importance to the visual appearance of the painted car skin as an indication of product quality. The “orange peel” phenomenon constitutes a major problem here. It is not only depending on the paint’s chemical composition and application method, but also on possible waviness components in the sheet substrate. Therefore one is searching hard for a valuable waviness parameter to quantify the substrate’s fitness for purpose. A technically emerging problem is how to remove the form from the measured signal, which is indeed not significant to the orange peel phenomenon. This paper will compare two commonly used approaches: i.e. Fourier filtering versus polynomial regression and will reveal and quantify some common aspects in terms of wavelengths