African tick bite fever is the most commonly encountered travel-associated rickettsiosis, occurring in as many as 5% of travelers returning from rural subequatorial Africa. This case report illustrates that rifampin represents an effective alternative to doxycycline for treatment of African tick bite fever in some selective situations.

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Background Lack of physicians’ knowledge regarding mental health, including Autism Spectrum Disorder (ASD) could have adverse effects on affected individuals’ health and quality of life. The purpose of this study was to provide construct validity for a modified questionnaire in order to determine the self-reported competency for underlying sub-constructs in ASD, make inferences on perceived competence in ASD based on a sample of Romanian physicians, and identify physicians’ characteristics associated with these sub-domains of competency. Methods For this survey, we modified a questionnaire that was used in Pakistan and Turkey, and administered it to a sample of 383 practicing physicians in Romania to assess their perceived competency regarding ASD. Exploratory factor analysis on 12 knowledge questions revealed five sub-domains: stigma, potential causes, children’s behavior, misconceptions, and educational needs associated with ASD knowledge. Using General Linear Models, we determined physicians’ characteristics that predict the total competency score and various competency sub-scores. Results Seventy-five percent of the responding physicians were female and 30% had over 30 years practicing medicine. The majority (73–94%) of physicians have correctly responded to some basic questions regarding knowledge about ASD. We also found that younger physicians were more knowledgeable about potential causes of ASD than older physicians (Adjusted Mean Score (AMS): 2.90 vs. 2.18, P < 0.01), while older physicians knew more about the behavior of children with ASD (AMS: 0.64 vs. 0.37, P = 0.02). We found a significant interaction (P < 0.01) between television as source of ASD knowledge and city where the clinic is located in relation to knowledge of the physicians regarding stigma related to ASD. However, the total score was not associated with the variables associated with sub-domains. Conclusion Using factor analysis, we demonstrated construct validity of five sub-domains related to Romanian physicians’ knowledge about ASD that include stigma, potential causes, behavior in ASD children, special education needs, and misconceptions related to ASD. The lack of significant association of the knowledge of physicians on ASD neither with the Psychiatry nor the Pediatric ward rotations at medical school may support the need for improving the curriculum on ASD in Romanian medical schools.

Background An inadequate level of general knowledge of physicians regarding mental health, including Autism Spectrum Disorder (ASD) not only could have adverse effects on affected individuals’ health and quality of life, but also could further delay its diagnosis and initiation of timely interventions. The purpose of this survey was to assess the level of knowledge, attitudes, and practices (KAP) of physicians regarding ASD in Romania and identify their associated factors. Methods For conducting this cross-sectional survey, investigators in the US collaborated with faculty at “Carol Davila” University of Medicine and Pharmacy (UMF) and developed a questionnaire by modifying similar questionnaires used in Pakistan and Turkey, to assess KAP of physicians and specialists regarding ASD in Romania. The Questionnaire was administered to a convenient sample of 383 practicing physicians or specialists. Exploratory Factor Analysis on 12 variables revealed five composite sub-scores: stigma, potential causes, children’s behavior, misconceptions, and educational needs associated with ASD knowledge. We determined the variables associated additively or interactively with KAP regarding ASD by applying General Linear Models to the five sub-scores as dependent variables. Results Approximately 75% of the responding physicians were female and more than 80% were over the age of 30 years. The majority (73%-94%) of physicians in Romania have correctly responded to some basic questions regarding knowledge about ASD. We also found that younger physicians (age < 35 years) were more knowledgeable about potential causes of ASD than older physicians, age ≥ 35 years, (adjusted mean sub-scores: 2.70 vs. 2.13, P = 0.04, adjusted for the “type of medical school attended” and “city where the clinic is located”), while older physicians knew more about the behavior of children with ASD (P = 0.02). We found a significant interaction between source of ASD knowledge and (city where the clinic is located) in relation to knowledge of the physicians’ regarding stigma related to ASD. There were no significant interactions in relation to the physician’s knowledge of behaviors of children with ASD. Conclusion Though Romanian physicians are knowledgeable about ASD, greater attention is needed on symptoms, causes, and awareness of stigma and misconceptions surrounding ASD.