BACKGROUND: Imported falciparum malaria in an increasingly frequent health problem in many areas in which it is not endemic. Complications are commonly seen, and reported case-fatality rates may exceed 3%. MATERIAL AND METHODS: The study is a medical chart-based retrospective study of all cases of falciparum malaria diagnosed in Oslo and Akershus counties, south-eastern Norway, 1988-1997. RESULTS: We identified 232 diagnosed cases; of these, records were available for 222 cases (95%). The incidence rate almost quadrupled during the study period. The two largest groups were immigrants visiting their country of origin (35%) and Norwegian tourists (29%). 95% of the cases were infected in Sub-Saharan Africa. There were no fatal cases, and only eight cases (3.6%) developed complicated falciparum malaria. In a statistical analysis, the following factors were found to be significantly associated with complicated disease: higher age, noncompliance to recommended chemoprophylaxis in assumed non-immune subjects, prolonged doctor's delay and prolonged diagnostic delay. INTERPRETATION: The study suggests that complications in imported falciparum malaria may largely be prevented by a high rate of chemoprophylaxis compliance in non-immune travellers and a high awareness of this possibility among physicians evaluating febrile travellers from endemic areas.
Female circumcision, or genital mutilation is practised around the world. Because of war, conflicts and poverty, many women from cultures involving this practice now enter European communities. Some of them demand circumcision for their children. Genital mutilation of women has serious health effects, and in our societies there is a strong demand for its eradication. The cultural reasons for genital mutilation are varied, but it is not a compulsory part of the Islamic faith. Health workers in Norway may lack knowledge on how to handle these women when they meet them in their daily work. Sometimes unnecessary interventions are performed, sometimes ignorance may cause traumatic experiences for both patient and doctor. This article describes some of the social and cultural background for continued exposure to female mutilation, the health effects and some suggestions for interventions.
All children with haemoglobin below 9.0 g/100 ml and iron deficiency treated in the Paediatric Department, Ullevål Hospital, from 1.1.1988 to 6.10.1992, were studied. 26 of the 29 registered children had parents born in developing countries. Median age was 16 months (9-134 months) and median haemoglobin was 6.8 g/100 ml (3.5-9.0 g/100 ml) at admission. There was a negative correlation between platelet count and haemoglobin concentration in blood (correlation coefficient -0.67, p
BACKGROUND: We wanted to describe diabetes (prevalence and types) and pregnancy outcomes among women with diabetes in a multiethnic population. MATERIAL AND METHODS: 509 pregnancies (231 from Asia/Africa and 278 from Norway) were assessed in a population-based, descriptive study of pregnancy with diabetes in Oslo 1993-1998. The outpatient clinic at Aker University Hospital provided information about pregnancies with diabetes and Statistics Norway provided population data. Data were analysed with frequency-analyses and cross-tables. RESULTS: The proportion of pregnancies with diabetes among women 15-49 years was seven times higher in the Asia/Africa group (1.8%, 95% CI = 1.6-2.1) than in the group of ethnic Norwegians (0.3%, 95% CI = 0.2-0.3). Gestational diabetes made up 80% of the diabetes cases among women born in Asia/Africa (13% of type 2 and 5% of type 1) and 48% of the cases among women born in Norway (5% were type 2 and 45% were type 1). In the group with manifest diabetes we found a body mass index > 30 kg/m2 in 42% for women from Asia/Africa and 12% for those from Norway. The percentage of Caesarean section was 37% in the Asia/Africa-group and 42% in the Norway-group. Almost 10% of the newborns in both groups had a birth weight > 4500 g. A postpartum glucose intolerance test for women with gestational diabetes showed that 26% of the women from Asia/Africa had type 2 diabetes and 12% of those from Norway. Information was missing for 43% of those from Asia/Africa and 35% of those from Norway. INTERPRETATION: Diabetes in pregnancy is much more prevalent in women from Asia/Africa than in women born in Norway. Women from Asia/Africa and Norway had different diabetes profiles. High birth weight and interventions in labour were frequent in both groups. Many with gestational diabetes had diabetes type 2.
Up to 1996, a total of 1,537 individuals had been reported as having HIV infection in Norway (population 4.3 million). 511 of these had developed AIDS and 410 had died from AIDS. 223 persons had acquired HIV heterosexually. Less than a fifth of these had acquired the infection from persons who themselves had been infected with HIV heterosexually in Norway. Named testing of pregnant women, recruits and blood donors confirms the limited spread of HIV. We estimate that the annual incidence of heterosexually acquired HIV infection has remained at 20-30 for the last ten years. Earlier prognoses for the epidemic in Norway were grossly erroneous, mainly owing to lack of knowledge about the factors determining the spread of HIV. Given the low rate of transmission of the virus and the sexual behaviour of Norwegians, there was never any real danger of a large heterosexual HIV epidemic in this country. The future efforts to combat the epidemic should focus on maintaining features that make Norwegian society less vulnerable to HIV.