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[Differences in morbidity between the Eastern central city district and the suburban Western district of Oslo].

Oslo, the capital of Norway, has a population of 500,000. Living conditions vary considerably within the city, and the mortality rate in the most deprived area is almost three times as high as in the most affluent one. We wanted to explore how morbidity varies within Oslo. We used four town-wide disease registers to study the prevalence of the four diseases in the most deprived and the most affluent part of the city. We found that tuberculosis occurs more frequently in the poor area, while type 1 diabetes mellitus in children occurs more frequently in the most affluent area. For multiple sclerosis and rheumatoid arthritis we could not find any differences between the areas.

Adult↗

[A clinical and biological study of parasitic and fungal diarrhea in immunosuppressed patients in an urban and suburban area of Yaoundé].

We studied 66 cases of intestinal mycosis and parasitosis in patients infected with the human immunodeficiency virus with chronic diarrhea. All subjects were from the Yaounde urban area and were followed between February and December 1996. They were recruited from 3 hospitals in the center of Yaounde and were aged between 2 and 52 years. There was weight loss in 80.3% and severe dehydration in 72.3% of cases. Feces consisted mostly of watery stools similar to those of cholera patients (50% of cases) and loose stools (43.9% of cases). Parasitic agents were detected in 31.8% and fungal agents in 80.5% of cases. The opportunistic Protozoans detected included Cryptosporidium parvum (15.8%), microsporidia (8.8%) and Isospora belli (3.5%). Six cases of helminthiasis were also identified. Candida albicans was the most common opportunistic mycosis agent (39.1%). Other fungal species detected included Geotrichum candidum, Candida pseudotropicalis and Trichosporon sp. but all of these were less common.

AIDS-Related Opportunistic Infections↗

Residential mobility between cities and suburbs: race, suburbanization, and back-to-the-city moves.

Information from the 1979 to 1986 waves of the Panel Study of Income Dynamics is merged with data on respondents' tract and metropolitan area of residence to examine patterns and determinants of residential mobility between central cities and suburbs. Consistent with the life-cycle model of residential mobility, mobility in both directions declines with age, but on balance the presence of young children deters moving to the suburbs. Among blacks, education increases the probability of moving from cities to suburbs, while high income retains blacks and whites in suburbs. Consistent with the place stratification model, blacks are substantially less likely than whites to move from cities to suburbs, and substantially more likely to move from suburbs to cities, even after standardizing for racial differences in sociodemographic characteristics. High levels of violent crime and unemployment in cities relative to suburbs also tend to spur city-to-suburb mobility or inhibit suburb-to-city moves.

Adolescent↗

[Organization and quality control of a clinical database on intensive care medicine in central and suburban Paris].

BACKGROUND: Epidemiology and medical care appraisal of intensive care medicine relies on the homogeneity of information systems. This work is about a collaborative database related to intensive care units in Paris and its suburb. METHODS: A college of intensivists defined a standard dataset about stays, outcomes, severity of illness, diagnoses and work load, which are collected and analysed by a data management center. A quality control of the database was performed on a random sample of 199 stays. RESULTS: In 1996, 25 intensive care units participated in the database which encompassed more than 35,000 stays. The control of data quality showed a good reliability of data about stays, severity and workload but reproducibility of diagnosis coding has to be improved by means of more accurate coding guidelines. CONCLUSION: This database of case-mix and outcome information allows comparison and medical care appraisal of intensive care units.

Critical Care↗

Human malaria: segregation analysis of blood infection levels in a suburban area and a rural area in Burkina Faso.

The genetic control of blood infection levels in human malaria remains unclear. Case control studies have not demonstrated a strong association between candidate genes and blood parasite densities as opposed to surveys that have focused on severe malaria. As an alternative approach, we used segregation analyses to determine the genetic control of blood parasitemia. We surveyed 509 residents (53 pedigrees) in a rural area and 389 residents (41 pedigrees) in an urban area during 18 months. Each family was visited 20 times and 28 times in the urban area and in the rural area; the mean number of parasitemia measurements per subject was 12.1 in the town and 14.9 in the village. The intensity of transmission of Plasmodium falciparum was 8-fold higher in the rural area than in the urban area. Using the class D regressive model for both populations, we found that blood parasite densities were correlated between sibs. We obtained strong evidence for a major effect, but we found that the transmission of this major effect was not compatible with a simple Mendelian model, suggesting a more complex mode of inheritance. Moreover, there was a strong interaction between major effect and age, suggesting that the influence of the putative major gene may be more prominent in children than in adults. Further nonparametric linkage studies, such as sib pair analysis, that focus on children would help us better understand the genetic control of blood infection levels.

Adolescent↗

Serum cholesterol level in a typical suburban commercial community in Nigeria.

Forty-one apparently healthy businessmen and -women and an equal number of government workers matched for age and sex underwent serum cholesterol determinations. The mean serum cholesterol levels of businessmen and -women were significantly higher than those of their government worker counterparts (p < 0.001). The marked increase in the serum cholesterol of the business subjects was attributed to their overindulgence and/or eating habits and lack of physical activity. The cardiovascular risk implications of the high cholesterol value and other risk co-factors such as obesity and alcoholism observed among the business subjects are highlighted. We advise that for communities similar to the one described here, public enlightenment programmes about the health benefits of periodic medical assessment and recreational physical activities are necessary. A further comprehensive study of lipid, lipoprotein and other risk factors in these subjects should be encouraged.

Adult↗