Comparative characteristics of epidemiology and clinics of multiple sclerosis in the south and north of Ukraine on the example of populations of the Nikolaev and Rivne regions | Ukrainian Medical Journal

Stoyanov O.M.,Ivaniuk A.V.,Grinchiuk A.D.,Borisenko O.A.,Bocherova T.I.

Main
Publications
Comparative characteristics of epidemiology and clinics of multiple sclerosis in the south and north of Ukraine on the example of populations of the Nikolaev and Rivne regions

Comparative characteristics of epidemiology and clinics of multiple sclerosis in the south and north of Ukraine on the example of populations of the Nikolaev and Rivne regions

January 23, 2020

896

Neurology and Psychiatry

Keywords :

female-to-male ratio,

multiple sclerosis,

onset,

prevalence

Specialities :

Neurology and Psychiatry

Resume

Aim — to analyze the epidemiological and clinical features of multiple sclerosis (MS) in patients living in the south and north of Ukraine using the populations of Nikolaev and Rivne regions. Methods. A descriptive cross-sectional study was conducted using clinical and epidemiological data of all MS patients registered in 11 districts of the Nikolaev region (DNR, n=118) and 3 districts of the Rivne region (DRR, n=105) with the same total population as of 2018 year. Data was collected using structured questionnaires sent to district medical institutions. The data obtained were analyzed by descriptive statistics using the χ² to determine the significance of differences between groups. Results. The female-to-male ratio for DNR was 1.62, for DRR — 1.56. In both regions, MS onset most often occurred at the age of 21–30 years (42.4 and 40.0% in DNR and DRR, respectively). In 72.0% of patients in DNR and 60.5% — in DRR, there was a gradual development of symptoms at the onset. The majority of DNR patients had polysymptomatic (74.6%) and monosymptomatic (11.0%) MS onset compared to DRR patients (66.7 and 7.6%, respectively; p=0.09). Significantly more patients in DNR had a secondary progressive phenotype (47 (39.0%) compared with DRR (14 (13.3%); p<0.00001). The number of relapses per year and Expanded Disability Status Scale (EDSS) index did not significantly differ between the groups. Conclusions. In contrast to DRR patients, DNR patients showed a tendency toward polysymptomatic onset of MS. Significantly more patients with DNR had a secondary progressive course, while in the DRR a relapsing-remitting phenotype prevailed. The female-to-male ratio, the age of the onset, the number of exacerbations per year, and the EDSS index did not differ significantly between the patients of the two regions.

Published: 23.01.2020

References:

Voloshin P.V., Voloshina N.P., Taitslin V.I. et al. (2007) Multiple sclerosis in Ukraine: prevalence, course, prognosis, treatment, pharmacoeconomics. Ukr. Visn. psychoneurol., 15(50): 6–21.
Voloshina N.P., Gritsay N.N., Dykan I.N. (2010) Multiple sclerosis: the urgency of the problem in Ukraine, modern aspects of immunopathogenesis, clinic, diagnosis and treatment. Konsp. Neurologist, 2: 30–51.
State Statistics Service of Ukraine (2019) Population of Ukraine on January 1, 2019: Stat. Zb. Kiev, 83 p.
Mishchenko T.S., Shulga O.D., Bobrik N.V., Shulga L.A. (2014) Multiple sclerosis: a global perspective. UMJ, 3(101): 84–87.
Pazhigova Z.B., Karpov S.M., Shevchenko P.P., Burnusus N.I. (2014) The prevalence of multiple sclerosis in the world (review article). J. Exp. Educ., 1–2: 78–82.
Alla S., Pearson J.F., Taylor B.V. et al. (2016) An investigation of the relationship between latitude and multiple sclerosis severity in New Zealand. Mult. Scler., 22(5): 705–707, doi: 10.1177/1352458515605909.
Becuş T., Popoviciu L. (1994) Epidemiologic survey of multiple sclerosis in Mureş County, Romania. Rom. J. Neurol. Psychiatry, 32(2): 115–122.
Berg-Hansen P., Moen S.M., Sandvik L. et al. (2015) Prevalence of multiple sclerosis among immigrants in Norway. Mult. Scler., 21(6): 695–702, doi: 10.1177/1352458514554055.
Brola W., Sobolewski P., Flaga S. et al. (2017) Increasing prevalence and incidence of multiple sclerosis in Poland. Neurol. Neurochir. Pol., 51(1): 82–85, doi: 10.1016/j.pjnns.2016.11.005.
Dobson R., Ramagopalan S., Davis A., Giovannoni G. (2013) Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude. J. Neurol. Neurosurg. Psychiatry, 84(8): 909–914, doi: 10.1136/jnnp-2012-304695.
Eskandarieh S., Heydarpour P., Minagar A. et al. (2016) Multiple sclerosis epidemiology in East Asia, South East Asia and South Asia: a systematic review. Neuroepidemiology, 46(3): 209–221, doi: 10.1159/000444019.
Etemadifar M., Mehrabi B., Kiani-Peykani R. et al. (2016) Soil heavy metals are associated with the distribution of multiple sclerosis in Isfahan, Iran. Acta Neurol. Scand., 134(4): 292–299, doi: 10.1111/ane.12543.
Häsänen E., Kinnunen E., Alhonen P. (1986) Relationships between the prevalence of multiple sclerosis and some physical and chemical properties of soil. The Science of the total environment, 58(3): 263–272, doi: 10.1016/0048-9697(86)90206-8.
Kurtzke J.F. (1975) A reassessment of the distribution of multiple sclerosis. Part one. Acta Neurol. Scandinav., 51(2): 110–136, doi: 10.1111/j.1600-0404.1975.tb01364.x.
Lonergan R., Kinsella K., Fitzpatrick P. et al. (2011) Multiple sclerosis prevalence in Ireland: relationship to vitamin D status and HLA genotype. J. Neurol. Neurosurg. Psychiatr., 82(3): 317–322, doi: 10.1136/jnnp.2010.220988.
Marcoci C., Lisnic V., Gavriliuc M. et al. (2016) Prevalence of multiple sclerosis in the republic of Moldova. Neuroepidemiology, 46(3): 166–172, doi: 10.1159/000443931.
Nakamura Y., Matsushita T., Sato S. et al.; Japan Multiple Sclerosis Genetics Consortium (2016) Latitude and HLA-DRB1*04:05 independently influence disease severity in Japanese multiple sclerosis: a cross-sectional study. J. Neuroinflammation, 13(1): 239, doi: 10.1186/s12974-016-0695-3.
Pivot D., Debouverie M., Grzebyk M. et al. (2016) Geographical heterogeneity of multiple sclerosis prevalence in France. PloS One, 11(12): e0167556, doi: 10.1371/journal.pone.0167556.
Spelman T., Gray O., Trojano M. et al. (2014) Seasonal variation of relapse rate in multiple sclerosis is latitude dependent. Ann. Neurol., 76(6): 880–890, doi: 10.1002/ana.24287.
Tao C., Simpson S.Jr., van der Mei I. et al.; MSBase Study Group (2016) Higher latitude is significantly associated with an earlier age of disease onset in multiple sclerosis. J. Neurol. Neurosurg. Psychiatr., 87(12): 1343–1349, doi: 10.1136/jnnp-2016-314013.
Thompson A.J., Banwell B.L., Barkhof F. et al. (2018a) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol., 17(2): 162–173. doi: 10.1016/S1474-4422(17)30470-2.
Thompson A.J., Baranzini S.E., Geurts J. et al. (2018b) Multiple sclerosis. Lancet, 391(10130): 1622–1636, doi: 10.1016/S0140-6736(18)30481-1.
Tsai C.P., Lee C.T. (2013) Multiple sclerosis incidence associated with the soil lead and arsenic concentrations in Taiwan. PloS One, 8(6): e65911, doi: 10.1371/journal.pone.0065911.
Zeman D., Kušnierová P., Hradílek P. (2019) Roztroušená skleróza: likvorové biomarkery zánětu a tkáňového poškození. Sympozium Dialog, Valeč, 72 p.