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Published in: Journal of Neurology 9/2006

01-09-2006 | ORIGINAL COMMUNICATION

Multiple sclerosis in Jordan: a clinical and epidemiological study

Authors: Khalid El-Salem, MD, Ehsan Al-Shimmery, MD, Khalid Horany, MD, Ali Al-Refai, MD, Kefah Al-Hayk, MD, Yousef Khader, BDS. MD

Published in: Journal of Neurology | Issue 9/2006

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Abstract

Objectives

To characterize the clinical, demographic and epidemiological features of multiple sclerosis (MS) in Jordan.

Methods

Data for consecutive Jordanian patients, fulfilling the McDonald criteria for clinically definite and clinically probable MS, during the time period 2004–2005 were collected and analyzed in the three major referral centers for MS in Jordan.

Results

We identified a total of 224 patients (165 females, 87%; 59 males, 13%). The mean (±SD) age of onset was 29.3 (±9.6) years, and mean (±SD) duration of illness was 3.9 (±9.3) years. The prevalence of MS in the city of Amman was 39/100,000. The prevalence of MS in Irbid, north Jordan, was 38/100,000. The most frequent presentation was weakness (30.8%), followed by optic neuritis (20.1%), sensory impairment (19.6%), and ataxia (14.3%). A relapsing remitting pattern was identified in 90.2% of patients, the rest being primary and secondary progressive, and one patient had a progressive relapsing course. Family history of MS was found in 9.4% of the cases. About 60% of the patients were using interferon beta. The degree of physical disability was determined using the Expanded Disability Status Scale (EDSS). Younger age of onset, shorter duration of illness, a relapsing remitting pattern, and use of interferon were identified as statistically significant predictors of less disability.

Conclusion

Jordan is a medium-high risk country for MS, with prevalence higher than what has previously been reported, possibly representing an increase in incidence. Clinical and demographic characteristics are similar to most reports worldwide.
Literature
1.
go back to reference Al-Araji A, Mohammed AI (2005) Multiple Sclerosis in Iraq: Does it have the same features encountered in Western countries. J Neurol Sci 15; 234(1–2):67–71CrossRef Al-Araji A, Mohammed AI (2005) Multiple Sclerosis in Iraq: Does it have the same features encountered in Western countries. J Neurol Sci 15; 234(1–2):67–71CrossRef
2.
go back to reference Alshubaili AF, Alramzy K, Ayyad YM, Gerish Y (2005) Epidemiology of multiple sclerosis in Kuwait: new trends in incidence and prevalence. Eur Neurol 53:125–131PubMedCrossRef Alshubaili AF, Alramzy K, Ayyad YM, Gerish Y (2005) Epidemiology of multiple sclerosis in Kuwait: new trends in incidence and prevalence. Eur Neurol 53:125–131PubMedCrossRef
3.
go back to reference Daif AK, Al-Rajeh S, Awada A, Al Bunyan M, AbdulJabar M, Al Tahan AR (1998) Pattern of presentation of multiple sclerosis in Saudi Arabia: analysis based on clinical and paraclinical features. Eur Neurol 39:182–186PubMedCrossRef Daif AK, Al-Rajeh S, Awada A, Al Bunyan M, AbdulJabar M, Al Tahan AR (1998) Pattern of presentation of multiple sclerosis in Saudi Arabia: analysis based on clinical and paraclinical features. Eur Neurol 39:182–186PubMedCrossRef
4.
go back to reference Detels R, Visscher BR, Malmgren RM, Coulson AH, Lucia MV, Dudley JP (1977) Evidence for lower susceptibility to multiple sclerosis in Japanese-Americans. Am J Epidemiol 105:303–310PubMed Detels R, Visscher BR, Malmgren RM, Coulson AH, Lucia MV, Dudley JP (1977) Evidence for lower susceptibility to multiple sclerosis in Japanese-Americans. Am J Epidemiol 105:303–310PubMed
5.
go back to reference Hamdi TI (1975) Multiple sclerosis in Iraq: a clinical and geomedical survey. J Postgr Med 21:1–9 Hamdi TI (1975) Multiple sclerosis in Iraq: a clinical and geomedical survey. J Postgr Med 21:1–9
6.
go back to reference Hogancamp WE, Rodriquez M, Weinshenker BG (1997) The epidemiology of multiple sclerosis. Mayo Clin Proc 72:871–878PubMedCrossRef Hogancamp WE, Rodriquez M, Weinshenker BG (1997) The epidemiology of multiple sclerosis. Mayo Clin Proc 72:871–878PubMedCrossRef
7.
go back to reference Hou JB, Zhang ZX (1992) Prevalence of multiple sclerosis: a door-to-door survey in Lan Cang La Hu Zu Autonomous County Yunnan Province of China. Neuroenidemiolonv 11:52 Hou JB, Zhang ZX (1992) Prevalence of multiple sclerosis: a door-to-door survey in Lan Cang La Hu Zu Autonomous County Yunnan Province of China. Neuroenidemiolonv 11:52
8.
go back to reference Kahana E, Zilber N, Abramson JH, Biton V, Leibowitz Y, Abramsky O (1994) Multiple sclerosis:genetic versus environmental etiology: epidemiology in Israel updated. J Neurol 241:341–346PubMedCrossRef Kahana E, Zilber N, Abramson JH, Biton V, Leibowitz Y, Abramsky O (1994) Multiple sclerosis:genetic versus environmental etiology: epidemiology in Israel updated. J Neurol 241:341–346PubMedCrossRef
9.
go back to reference Kurdi A, Abdallat A, Ayesh I, Maayta U (1977) Different B lymphocyte alloantigens associated with multiple sclerosis in Arabs and Northern Europeans. Lancet 1(8022):1123–1125PubMedCrossRef Kurdi A, Abdallat A, Ayesh I, Maayta U (1977) Different B lymphocyte alloantigens associated with multiple sclerosis in Arabs and Northern Europeans. Lancet 1(8022):1123–1125PubMedCrossRef
10.
go back to reference Kuroiwa Y, Igata A, Itahara K, Koshijima S, Tsubaki T (1975) Nationwide survey of multiple sclerosis in Japan: clinical analysis of 1,084 cases. Neurology 25(9): 845–851PubMed Kuroiwa Y, Igata A, Itahara K, Koshijima S, Tsubaki T (1975) Nationwide survey of multiple sclerosis in Japan: clinical analysis of 1,084 cases. Neurology 25(9): 845–851PubMed
11.
go back to reference McDonald WI, Compston A, Edan G, Goodkin D, Hartnup HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol 50(1):121–127PubMedCrossRef McDonald WI, Compston A, Edan G, Goodkin D, Hartnup HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol 50(1):121–127PubMedCrossRef
12.
go back to reference Najim A, El-Khateeb M, Kurdi A, Mubaidin A, Wriekat A, Al-Shehab A, Khalil R (1995) Multiple sclerosis in Arabs in Jordan. J Neurol Sci 131(2):144–149CrossRef Najim A, El-Khateeb M, Kurdi A, Mubaidin A, Wriekat A, Al-Shehab A, Khalil R (1995) Multiple sclerosis in Arabs in Jordan. J Neurol Sci 131(2):144–149CrossRef
13.
go back to reference Najim Al-Din AS, Khogali M, Poser CM, Al-Nassar KE, Shakir R, Hussain J, Behbahani K, Ghadha G (1990) Epidemiology of multiple sclerosis in Arabs in Kuwait: a comparative study between Kuwaitis and Palestinians. J Neurol Sci 100(1–2):137–141CrossRef Najim Al-Din AS, Khogali M, Poser CM, Al-Nassar KE, Shakir R, Hussain J, Behbahani K, Ghadha G (1990) Epidemiology of multiple sclerosis in Arabs in Kuwait: a comparative study between Kuwaitis and Palestinians. J Neurol Sci 100(1–2):137–141CrossRef
14.
go back to reference Najim Al-Din AS, Kurdi A, Mubaidin A, El-Khateeb M, Khalil RW, Wriekat A (1996) Epidemiology of multiple sclerosis in Arabs in Jordan: a comparative study between Jordanians and Palestinians. J Neurol Sci 135:162–7PubMedCrossRef Najim Al-Din AS, Kurdi A, Mubaidin A, El-Khateeb M, Khalil RW, Wriekat A (1996) Epidemiology of multiple sclerosis in Arabs in Jordan: a comparative study between Jordanians and Palestinians. J Neurol Sci 135:162–7PubMedCrossRef
15.
go back to reference Poser CM (1994) The epidemiology of multiple sclerosis: a general overview. Ann Neurol 36 (SuppI): S180–S193PubMedCrossRef Poser CM (1994) The epidemiology of multiple sclerosis: a general overview. Ann Neurol 36 (SuppI): S180–S193PubMedCrossRef
16.
go back to reference Pugliatti M, Sotgiu S, Rosati G (2002) The worldwide prevalence of multiple sclerosis. Clin Neurol Neurosurg 104: 182–191PubMedCrossRef Pugliatti M, Sotgiu S, Rosati G (2002) The worldwide prevalence of multiple sclerosis. Clin Neurol Neurosurg 104: 182–191PubMedCrossRef
17.
go back to reference Marrie RA (2004) Environmental risk factors in multiple sclerosis etiology. Lancet Neurol 3:709–718PubMedCrossRef Marrie RA (2004) Environmental risk factors in multiple sclerosis etiology. Lancet Neurol 3:709–718PubMedCrossRef
18.
go back to reference Sadovnick A, Ebers G (1993) Epidemiology of multiple sclerosis: a critical overview. Can J Neurol Sci 20:17–29PubMed Sadovnick A, Ebers G (1993) Epidemiology of multiple sclerosis: a critical overview. Can J Neurol Sci 20:17–29PubMed
19.
go back to reference Yakub BA, Daif AK (1988) Multiple sclerosis in Saudi Arabia. Neurology 38:621–623 Yakub BA, Daif AK (1988) Multiple sclerosis in Saudi Arabia. Neurology 38:621–623
Metadata
Title
Multiple sclerosis in Jordan: a clinical and epidemiological study
Authors
Khalid El-Salem, MD
Ehsan Al-Shimmery, MD
Khalid Horany, MD
Ali Al-Refai, MD
Kefah Al-Hayk, MD
Yousef Khader, BDS. MD
Publication date
01-09-2006
Publisher
Steinkopff-Verlag
Published in
Journal of Neurology / Issue 9/2006
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-006-0203-2

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