Folkehelseinstituttet
Not a member yet
10872 research outputs found
Sort by
Fracture liaison service (FLS) is associated with lower subsequent fragility fracture risk and mortality: NoFRACT (the Norwegian capture the fracture initiative)
Full text linkSummary Subsequent fracture rates and associated mortality were compared before and after the introduction of fracture liaison service (FLS). In 100,198 women and men, FLS was associated with 13% and 10% lower risk of subsequent fragility fractures and 18% and 15% lower mortality. The study suggests that FLS may prevent fractures. Purpose Efficient fracture prevention strategies are warranted to control the global fracture burden. We investigated the effect of a standardized fracture liaison service (FLS) intervention on subsequent fracture risk and mortality. Methods The NoFRACT study was designed as a multicenter, pragmatic, register-supported, stepped-wedge cluster-randomized trial. The FLS intervention was introduced in three clusters with 4-month intervals starting May 2015 through December 2018 and included evaluation of osteoporosis and treatment in patients over 50 years with a low-energy fracture. Based on data from the Norwegian Patient Registry, patients with index fractures were assigned to the control period (2011–2015) or intervention period (2015–2018) depending on the time of fracture. Rates of subsequent fragility fractures (distal forearm, proximal humerus, or hip) and all-cause mortality were calculated. Results A total of 100,198 patients (mean age 69.6 years) suffered an index fracture of any type. During a maximum follow-up of 4.7 years, 11% (6948) of the women and 6% (2014) of the men experienced a subsequent fragility fracture, and 20% (14,324) of the women and 22% (8,326) of the men died. FLS was associated with 13% lower subsequent fragility fracture risk in women (hazard ratio (HR) 0.87, 95% confidence intervals (CI) 0.83–0.92) and 10% in men (HR 0.90, 95% CI 0.81–0.99) and 18% lower mortality in women (HR 0.82, 95% CI 0.79–0.86) and 15% in men (HR 0.85, 95% CI 0.81–0.89). Conclusion A standardized FLS intervention was associated with a lower risk of subsequent fragility fractures and mortality and may contribute to reduce the global fracture burden.publishedVersio
Number of people treated for hepatitis C virus infection in 2014-2023 and applicable lessons for new HBV and HDV therapies
Full text linkBackground and aims: The year 2023 marked the 10-year anniversary of the launch of direct-acting antivirals (DAAs) for the treatment of the hepatitis C virus (HCV). HCV treatment trends by country, region, and globally are important to monitor progress toward the World Health Organization's 2030 elimination targets. Additionally, the historical patterns can help predict the treatment uptake for future therapies for other liver diseases. Methods: The number of people living with HCV (PLHCV) treated between 2014-2023 across 119 countries was estimated using national HCV registries, reported DAA sales data, pharmaceutical companies' reports, and estimates provided by national experts. For the countries with no available data, the average estimate of the corresponding Global Burden of Disease region was used. Results: An estimated 13,816,000 (95% uncertainty intervals (UI): 13,221,000-16,415,000) PLHCV were treated, of whom 12,748,000 (12,226,000-15,231,000) were treated with DAAs, of which 11,081,000 (10,542,000-13,338,000) were sofosbuvir-based DAA regimens. Country-level data accounted for 97% of these estimates. In high-income countries, there was a 41% drop in treatment from its peak, and reimbursement was a large predictor of treatment. In low- and middle-income countries, price played an important role in expanding treatment access through the public and private markets, and treatment continues to increase slowly after a sharp drop at the end of the Egyptian national program. Conclusions: In the last 10 years, 21% of all HCV infections were treated with DAAs. Regional and temporal variations highlight the importance of active screening strategies. Without program enhancements, the number of treated PLHCV stalled in every country/region which may not reflect a lower prevalence but may instead reflect the diminishing returns of the existing strategies. Impact and implications: Long-term hepatitis C virus (HCV) infection can lead to cirrhosis and liver cancer. Since 2014, these infections can be effectively treated with 8-12 weeks of oral therapies. In 2015, the World Health Organization (WHO) established targets to eliminate HCV by 2030, which included treatment targets for member countries. The current study examines HCV treatment patterns across 119 countries and regions from 2014 to 2023 to assess the impact of national programs. This study can assist physicians and policymakers in understanding treatment patterns within similar regions or income groups and in utilizing historical data to refine their strategies in the future.publishedVersio
Hearing and cognitive scores measured with the Montreal Cognitive Assessment Scale in The HUNT Study, Norway
Full text linkpublishedVersio
Key factors in screening for extended-spectrum beta-lactamase (ESBL)-producing bacteria and carbapenemase-producing organism (CPO): A narrative synthesis of current evidence
Full text linkBackground and aim Extended-spectrum beta-lactamases (ESBLs) are enzymes produced by gram-negative bacteria that inhibit the effect of the most common types of betalactam antibiotics. Carbapenemase-producing organisms (CPO) possess mechanisms that also make them resistant to broad-spectrum betalactams. These bacteria are significant in the context of infection prevention and control (IPC) measures in healthcare due to its resistance mechanisms, high disease burden and limited treatment options. National prevention guidelines in Norway and Denmark were updated in 2015 and 2018, respectiveely. In 2023, the Norwegian Institute of Public Health (NIPH) and the Statens Serum Institut (SSI) decided to collaborate on proposals for new national recommendations for screening targeting resistant microbes of special significance to healthcare. We conducted literature reviews to update screening recommendations for resistant microbes in healthcare. This literature review is part of a series of reviews aimed at providing evidence to support this process. Methods We systematically searched five databases for systematic reviews and primary literature from the Nordic countries and the Netherlands. Inclusion criteria included whether outcomes were duration of colonisation, risk of transmission, prevalence of ESBL-producing bacteria and CPO among different patient populations and in different settings, or individual factors associated with ESBL/CPO- colonisation or infection. We excluded studies on treatment, management, laboratory methods, drug resistance, and environmental screening. We did not to include a discussion section in this report, as the interpretation of the results will be addressed in a more comprehensive assessment, which will incorporate all evidence syntheses along with other considerations. Results We found 437 systematic reviews and 52 primary studies to be relevant. Assessments of duration of colonisation and long-time carriage remain challenging based on identified studies, but there might be a trend that persistent colonisation decreases over time. Evidence on risk of infection/ colonisation with ESBL-producing bacteria and CPO after exposure is limited to a few settings in the systematic reviews found. The exposure may increase the risk of transmission, but the evidence is scarce. Studies on prevalence in different setting showed a relatively high prevalence of resistance in countries outside the Nordic region, especially in Southeast Asia and Africa. Studies on asylum seekers and refugees found a colonisation rate of multidrug-resistant bacteria up to 45%. Associated factors with ESBL/CPO colonisation were travel to countries outside Europe and medical travel. Other associated factors were prior antibiotic use, surgery, mechanical ventilation and catheter use. Conclusion This overview showed that persistent ESBL/CPO colonization can decrease over time. Documentation on the risk of transmission remains inconclusive. Important associated factors for ESBL/CPO colonization include travel to countries outside of Europe, medical travel, use of antibiotics, surgery, respiratory therapy, and catheter use. The studies also showed a high prevalence of colonization among asylum seekers and refugees.publishedVersio
Incidence of childhood and youth epilepsy: A population-based prospective cohort study utilizing current International League Against Epilepsy classifications for seizures, syndromes, and etiologies
Full text linkpublishedVersio
Safety of frozen and dried forms of whole yellow mealworm (Tenebrio molitor larva) as a novel food pursuant to Regulation (EU) 2015/2283
No full textpublishedVersio
