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01-12-2020 | Multiple Sclerosis | Research article

Evidence of an increased prevalence of multiple sclerosis: a population-based study of Tehran registry during 1999–2018

Authors: Amir Almasi-Hashiani, Mohammad Ali Sahraian, Sharareh Eskandarieh

Published in: BMC Neurology | Issue 1/2020

Abstract

Background

The epidemiological characteristics of multiple sclerosis (MS) have been investigated in various studies, which have revealed that the prevalence of MS varies across countries. The present study was conducted to investigate the longitudinal prevalence of MS in Tehran, Iran.

Methods

The present population-based study was conducted in Tehran, the capital of Iran from 1999 to 2018 based on the annual report data provided by the Iranian MS Society (IMSS) registry system. The age-standardized and crude prevalence were estimated using population data presented by the Statistical Centre of Iran.

Results

A total of 21,580 MS cases were registered and included in the analysis. Among the participant patients, 24.99% (5393) and 75.01% (16,187) of cases were male and female, respectively. The mean age of MS onset was 28.8 years (S.D: 8.7). The age-standardized prevalence (ASP) of MS increased from 73.7 (95%CI: 72.1–75.2) per 100,000 people in 2006 to 137.6 (95% CI: 135.7–139.5) per 100,000 people in 2018. The ASP of MS in 2018 was estimated to be 67.9 (95%CI: 66.0–69.8) and 207.3 (95%CI: 204.0–210.7) per 100,000 people among males and females, respectively. The age-standardized female-to-male ratio of MS ranged from 3.7 (in 2010) to 2.06 (in 2017).

Conclusion

The findings of this study suggested that the prevalence of MS in Tehran province is relatively high, and the occurrence of the disease is more common in the age groups under 40 years as compared with older-aged groups. In line with reports provided for various regions of the world, the prevalence of MS was higher among women. Similarly, the findings of this study revealed that the female-to-male ratio was 2.14 in 2018.

García-Domínguez JM, Maurino J, Martínez-Ginés ML, Carmona O, Caminero AB, Medrano N, et al. Economic burden of multiple sclerosis in a population with low physical disability. BMC Public Health. 2019;19(1):609. https://doi.org/10.1186/s12889-019-6907-x.CrossRefPubMedPubMedCentral

Stenager E. A global perspective on the burden of multiple sclerosis. Lancet Neurol. 2019;18(3):227–8. https://doi.org/10.1016/S1474-4422(18)30498-8.CrossRefPubMed

Wallin MT, Culpepper WJ, Campbell JD, Nelson LM, Langer-Gould A, Marrie RA, et al. The prevalence of MS in the United States: a population-based estimate using health claims data. Neurology. 2019;92(10):e1029–e40. https://doi.org/10.1212/wnl.0000000000007035.CrossRefPubMedPubMedCentral

Wallin MT, Culpepper WJ, Nichols E, Bhutta ZA, Gebrehiwot TT, Hay SI, et al. Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol. 2019;18(3):269–85. https://doi.org/10.1016/S1474-4422(18)30443-5.CrossRef

Al-Sakran LH, Marrie RA, Blackburn DF, Knox KB, Evans CD. Establishing the incidence and prevalence of multiple sclerosis in Saskatchewan. Can J Neurol Sci. 2018;45(3):295–303. https://doi.org/10.1017/cjn.2017.301.CrossRefPubMed

Eskandarieh S, Allahabadi NS, Sadeghi M, Sahraian MA. Increasing prevalence of familial recurrence of multiple sclerosis in Iran: a population based study of Tehran registry 1999–2015. BMC Neurol. 2018;18(1):15. https://doi.org/10.1186/s12883-018-1019-2.CrossRefPubMedPubMedCentral

Eskandarieh S, Heydarpour P, Elhami SR, Sahraian MA. Prevalence and incidence of multiple sclerosis in Tehran, Iran. Iran J Public Health. 2017;46(5):699–704.PubMedPubMedCentral

Hosseinzadeh A, Baneshi MR, Sedighi B, Kermanchi J, Haghdoost AA. Geographic variations of multiple sclerosis in Iran: a population based study. Multiple Sclerosis Relat Disord. 2019;28:244–9. https://doi.org/10.1016/j.msard.2019.01.001.CrossRef

Alonso A, Hernán MA. Temporal trends in the incidence of multiple sclerosis: a systematic review. Neurology. 2008;71(2):129–35.CrossRef

10.

Kurtzke J. Epidemiology of multiple sclerosis. Does this really point toward an etiology? Lectio Doctoralis. Neurol Sci. 2000;21(6):383.CrossRef

11.

Kurtzke JF. A reassessment of the distribution of multiple sclerosis. Acta Neurol Scand. 1975;51(2):137–57. https://doi.org/10.1111/j.1600-0404.1975.tb01365.x.CrossRefPubMed

12.

Eskandarieh S, Molazadeh N, Moghadasi AN, Azimi AR, Sahraian MA. The prevalence, incidence and familial recurrence of multiple sclerosis in Tehran, Iran. Multiple Sclerosis Relat Disord. 2018;25:143. https://doi.org/10.1016/j.msard.2018.07.023.CrossRef

13.

Shahin S, Eskandarieh S, Moghadasi AN, Razazian N, Baghbanian SM, Ashtari F, et al. Multiple sclerosis national registry system in Iran: validity and reliability of a minimum data set. Multiple Sclerosis Relat Disord. 2019;33:158–61. https://doi.org/10.1016/j.msard.2019.06.009.CrossRef

14.

Polman CH, Reingold SC, Edan G, Filippi M, Hartung H-P, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald criteria”. Ann Neurol. 2005;58(6):840–6. https://doi.org/10.1002/ana.20703.CrossRefPubMed

15.

National Institutes of Health. Standard Populations - 19 Age Groups. https://seer.cancer.gov/stdpopulations/stdpop.19ages.html (2019). Accessed July 2019.

16.

Statistical Center of Iran. Selected Findings of the 2011 National Population and Housing Census. https://www.amar.org.ir/Portals/1/Iran/Atlas_Census_2011.pdf (2014). Accessed September 2019.

17.

Statistical Center of Iran. Results of the 2016 National Population and Housing Census. https://www.amar.org.ir/Portals/0/census/1395/results/ch_nsonvm_95.pdf (2018). Accessed September 2019.

18.

Eskandarieh S, Heydarpour P, Minagar A, Pourmand S, Sahraian MA. Multiple sclerosis epidemiology in East Asia, South East Asia and South Asia: a systematic review. Neuroepidemiology. 2016;46(3):209–21. https://doi.org/10.1159/000444019.CrossRefPubMed

19.

Kurtzke JF. Multiple sclerosis in time and space--geographic clues to cause. J Neuro-Oncol. 2000;6(Suppl 2):S134–40.

20.

Dehghani R, Yunesian M, Sahraian MA, Gilasi HR, Kazemi MV. The evaluation of multiple sclerosis dispersal in Iran and its association with urbanization, life style and industry. Iran J Public Health. 2015;44(6):830–8.PubMedPubMedCentral

21.

Conway DS. What is the impact of socioeconomic status on multiple sclerosis? About multiple sclerosis. Neurology. 2019;92(13):e1536–e9.CrossRef

22.

Calocer F, Dejardin O, Droulon K, Launoy G, Defer G. Socio-economic status influences access to second-line disease modifying treatment in Relapsing Remitting Multiple Sclerosis patients. PLoS One. 2018;13(2):e0191646. https://doi.org/10.1371/journal.pone.0191646.CrossRefPubMedPubMedCentral

23.

Mehrpour M, Shams-Hosseini NS, Rezaali S, Sahraiian MA, Taki S. Effect of air pollutant markers on multiple sclerosis relapses. Iran J Public Health. 2013;42(10):1167–73.PubMedPubMedCentral

24.

Esmaeil Mousavi S, Heydarpour P, Reis J, Amiri M, Sahraian MA. Multiple sclerosis and air pollution exposure: Mechanisms toward brain autoimmunity. Med Hypotheses. 2017;100:23–30. https://doi.org/10.1016/j.mehy.2017.01.003.CrossRef

25.

Ashtari F, Esmaeil N, Mansourian M, Poursafa P, Mirmosayyeb O, Barzegar M, et al. An 8-year study of people with multiple sclerosis in Isfahan, Iran: association between environmental air pollutants and severity of disease. J Neuroimmunol. 2018;319:106–11. https://doi.org/10.1016/j.jneuroim.2018.02.019.CrossRefPubMed

26.

Mohebi F, Eskandarieh S, Mansournia MA, Mohajer B, Sahraian MA. Multiple sclerosis in Tehran: rising prevalence alongside stabilizing incidence - true increase or enhanced diagnosis? Arch Iran Med. 2019;22(8):429–34.PubMed

27.

Jamaati H, Attarchi M, Hassani S, Farid E, Seyedmehdi SM, Pormehr PS. Investigating air quality status and air pollutant trends over the Metropolitan Area of Tehran, Iran over the past decade between 2005 and 2014. Environ Health Toxicol. 2018;33(2):e2018010-e. https://doi.org/10.5620/eht.e2018010.CrossRef

28.

Bai L, Burnett RT, Kwong JC, Hystad P, van Donkelaar A, Brook JR, et al. Long-term exposure to air pollution and the incidence of multiple sclerosis: a population-based cohort study. Environ Res. 2018;166:437–43. https://doi.org/10.1016/j.envres.2018.06.003.CrossRefPubMed

29.

Heydarpour P, Amini H, Khoshkish S, Seidkhani H, Sahraian MA, Yunesian M. Potential impact of air pollution on multiple sclerosis in Tehran, Iran. Neuroepidemiology. 2014;43(3–4):233–8. https://doi.org/10.1159/000368553.CrossRefPubMed

30.

Orton S-M, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD, et al. Sex ratio of multiple sclerosis in Canada: a longitudinal study. Lancet Neurol. 2006;5(11):932–6. https://doi.org/10.1016/S1474-4422(06)70581-6.CrossRef

31.

Koch-Henriksen N, Sorensen PS. The changing demographic pattern of multiple sclerosis epidemiology. Lancet Neurol. 2010;9(5):520–32. https://doi.org/10.1016/s1474-4422(10)70064-8.CrossRefPubMed

32.

Börü ÜT, Bilgiç AB, Köseoğlu Toksoy C, Yılmaz AY, Tasdemir M, Sensöz NP, et al. Prevalence of multiple sclerosis in a Turkish City bordering an Iron and steel factory. J Clin Neurol. 2018;14(2):234–41. https://doi.org/10.3988/jcn.2018.14.2.234.CrossRefPubMedPubMedCentral

33.

Heydarpour P, Khoshkish S, Abtahi S, Moradi-Lakeh M, Sahraian MA. Multiple sclerosis epidemiology in Middle East and North Africa: a systematic review and meta-analysis. Neuroepidemiology. 2015;44(4):232–44. https://doi.org/10.1159/000431042.CrossRefPubMed

34.

Statistical Center of Iran. Labor force participation rate. https://irandataportal.syr.edu/wp-content/uploads/Labor-force-participation-rate.xlsx Accessed April 2020 2020.

35.

Bostrom I, Stawiarz L, Landtblom AM. Sex ratio of multiple sclerosis in the National Swedish MS Register (SMSreg). Multiple Sclerosis. 2013;19(1):46–52. https://doi.org/10.1177/1352458512446169.CrossRefPubMed

36.

Simpson S Jr, Pittas F, van der Mei I, Blizzard L, Ponsonby AL, Taylor B. Trends in the epidemiology of multiple sclerosis in greater Hobart, Tasmania: 1951 to 2009. J Neurol Neurosurg Psychiatry. 2011;82(2):180–7. https://doi.org/10.1136/jnnp.2010.215186.CrossRefPubMed

37.

Trojano M, Lucchese G, Graziano G, Taylor BV, Simpson S, Jr., Lepore V, et al. Geographical variations in sex ratio trends over time in multiple sclerosis. PLoS One. 2012;7 \:e48078-e; doi: https://doi.org/10.1371/journal.pone.0048078.CrossRef

38.

Holmberg M, Murtonen A, Elovaara I, Sumelahti M-L. Increased female MS incidence and differences in gender-specific risk in medium- and high-risk regions in Finland from 1981–2010. Mult Scler Int. 2013;2013:6. https://doi.org/10.1155/2013/182516.CrossRef

39.

Greer JM, McCombe PA. Role of gender in multiple sclerosis: clinical effects and potential molecular mechanisms. J Neuroimmunol. 2011;234(1–2):7–18. https://doi.org/10.1016/j.jneuroim.2011.03.003.CrossRefPubMed

40.

Chung S-E, Cheong H-K, Park J-H, Kim HJ. Burden of disease of multiple sclerosis in Korea. Epidemiol Health. 2012;34:e2012008-e. https://doi.org/10.4178/epih/e2012008.CrossRef

41.

Mansouri S, Zayeri F. Global and regional trends of multiple sclerosis disability-adjusted life years rates: a 25-year assessment. Neuroepidemiology. 2019;52(1–2):17–24. https://doi.org/10.1159/000492819.CrossRefPubMed

Title: Evidence of an increased prevalence of multiple sclerosis: a population-based study of Tehran registry during 1999–2018
Authors: Amir Almasi-Hashiani
Mohammad Ali Sahraian
Sharareh Eskandarieh
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Multiple Sclerosis
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-020-01747-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evidence of an increased prevalence of multiple sclerosis: a population-based study of Tehran registry during 1999–2018

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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