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Absence of focal neurological involvement in tick‐borne relapsing fever in northern Tanzania
Author(s) -
Mayegga E.,
Ljøstad U.,
Mygland Å.,
Monstad P.
Publication year - 2005
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2005.01003.x
Subject(s) - medicine , incidence (geometry) , vomiting , malaise , tanzania , nausea , population , pediatrics , tick , physical examination , surgery , veterinary medicine , physics , environmental science , environmental health , environmental planning , optics
The aim of the study was to chart incidence and clinical features of tick‐borne relapsing fever in Tanzania. Consecutive patients with fever and spirochetes demonstrated in a thick blood smear at Haydom Lutheran Hospital from 1 January to 31 December 2003 underwent clinical and cerebrospinal fluid (CSF) examination. Forty‐four patients were included, making an estimated minimum annual incidence of 11 per 100 000 population in this region. The mortality rate was 2.3% (95% CI = 0–12). The most frequent complaints were generalized malaise (93%), headache (86%), nausea and vomiting (52%). None of the patients [0% (95% CI = 0–8)] had focal neurological symptoms. Cell count in CSF was normal in 22 and slightly elevated (6–12 leukocytes/mm 3 ) in 20 patients. Two of three pregnancies had a poor outcome. Jarisch–Herxheimer reactions, bleeding complications and ocular manifestations were infrequent. In conclusion, tick‐borne relapsing fever is a common disease in the Northern highland of Tanzania, but in contrast to other parts of the world, neurological involvement is uncommon in this area.