1
|
Mallawaarachchi G, Rog DJ, Das J. Ethnic disparities in the epidemiological and clinical characteristics of multiple sclerosis. Mult Scler Relat Disord 2024; 81:105153. [PMID: 38043364 DOI: 10.1016/j.msard.2023.105153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/13/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a neuroinflammatory disorder which affects 2.8 million people world-wide. A growing body of evidence shows ethnic disparities in MS. This review aims to evaluate differences, based upon ethnic background, in the incidence, prevalence, disease course, and efficacy of disease-modifying therapies (DMTs) among people with MS (PwMS). METHOD Ethnicities were classified as White, Black, Hispanic, Asian, and Middle Eastern and North African (MENA). A literature search was conducted using the PubMed search engine to identify articles on MS and ethnicity that were published in the English language between 01/01/2005 and 31/05/2022. RESULTS 101 studies met all inclusion criteria. Although the incidence and prevalence of MS varied among ethnicities, findings were inconsistent and depended on the continent of the study. Ethnicity may have an impact on the disease course. PwMS from Black, Hispanic, and MENA, but not Asian ethnicities, appeared to accumulate physical disability at a faster rate than those from White ethnicity. Although there was a lack of studies evaluating the relative safety and efficacy of DMTs among various ethnicities, interferon-beta was found to be less efficacious in PwMS from Black ethnicity. CONCLUSIONS Further studies, with more uniform definitions of ethnicity are required to comprehensively understand ethnic disparities in MS, in particular to identify underlying causes, to facilitate the delivery of personalised medical care and avoid inequity.
Collapse
Affiliation(s)
| | - David J Rog
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford, United Kingdom M6 8HD
| | - Joyutpal Das
- University of Manchester, Oxford Rd, Manchester, United Kingdom M13 9PL; Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford, United Kingdom M6 8HD.
| |
Collapse
|
2
|
Dastoorpoor M, Nabavi SM, Majdinasab N, Zare Javid A, Ahmadi Angali K, Seyedtabib M. A case-control study of drinking beverages and the risk of multiple sclerosis in Iran. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:22. [PMID: 36959679 PMCID: PMC10037787 DOI: 10.1186/s41043-023-00364-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND There is no study in the world on the relationship between consuming black and green tea as beverages containing polyphenols and the risk of MS. This study aimed to determine the association between the consumption of green and black tea, coffee, non-alcoholic beer, milk, fruit juices and carbonated beverages with the risk of MS. METHODS AND MATERIALS This case-control study was performed on 150 patients with MS and 300 healthy individuals as a control group among patients who were referred to the ophthalmology ward of a referral hospital in Ahvaz with the groups matching for age. The data collection tool was a researcher-made questionnaire including demographic information and beverage consumption. Analysis was performed using univariate and multiple logistic regression models. RESULTS The mean age of patients at the time of diagnosis was 38.55 ± 8.88 years. The results showed that drinking milk (OR = 5.46), natural juice (OR = 2.49), and carbonated beverages (OR = 16.17) were associated with an increased chance of developing MS. However, drinking non-alcoholic beer (OR = 0.48), black tea (OR = 0.20), green tea (OR = 0.29) and coffee (OR = 0.07) were associated with a reduced chance of developing MS. CONCLUSION The results show that drinking black and green tea, non-alcoholic beer, and coffee are associated with a decrease in the chance of developing MS. The results of this study can be used to design interventional research and to change people's lifestyles to prevent MS.
Collapse
Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Massood Nabavi
- Department of Regenerative Biomedicine, Royan Institute for Stem Cell Biology and Technology, ACCR, Tehran, Iran
- Department of Brain and Cognition, Royan Institute for Stem Cell Biology and Technology, ACCR, Tehran, Iran
| | - Nastaran Majdinasab
- Department of Neurology, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Zare Javid
- Department of Nutritional Sciences, School of Allied Medical Sciences, Nutrition, and Metabolic Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Ahmadi Angali
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Seyedtabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| |
Collapse
|
3
|
Bahmani E, Hoseini R, Amiri E. The effect of home-based aerobic training and vitamin D supplementation on fatigue and quality of life in patients with multiple sclerosis during COVID-19 outbreak. Sci Sports 2022; 37:710-719. [PMID: 36119949 PMCID: PMC9464579 DOI: 10.1016/j.scispo.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/31/2021] [Indexed: 11/26/2022]
|
4
|
Farzinmehr S, Hosseini S, Kamali H, Moghadasi AN, Poursadeghfard M, Sharifi MH. Association of self-reported adherence to the Mediterranean diet with anthropometric indices, comorbidities, and degree of disability in patients with multiple sclerosis. Mult Scler Relat Disord 2022; 66:104060. [PMID: 35908448 DOI: 10.1016/j.msard.2022.104060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/28/2022] [Accepted: 07/15/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND One of the important challenges in the treatment of patients with multiple sclerosis (MS) is determining the effective factors in the treatment of MS, including dietary adherence. The aim of this study was to investigate the relationship between adherence to the Mediterranean diet with anthropometric indices and the expanded disability status scale (EDSS) scores in patients with MS. MATERIAL AND METHODS The present multicenter and cross-sectional study was conducted on patients with clinically definite MS (according to the 2017 revised McDonald criteria) who were referred to the MS clinics at medical centers affiliated to Shiraz and Tehran Universities of Medical Sciences during 2019. Disease phenotype, EDSS, waist circumference (WC), body mass index (BMI), and comorbidities were assessed. Adherence to the Mediterranean diet was measured with a 14-item modified Mediterranean Diet Adherence Questionnaire. In this questionnaire, a score of 0-5 indicates low adherence, a score of 6-9 shows moderate adherence, and a score of 10 and above demonstrates high adherence (healthy eating pattern). RESULTS This study was performed on 478 patients with a mean age of 37.99 ± 9.60 years, out of which 352 patients (73.6%) were female. The percentage of low, medium, and high adherence to the Mediterranean diet in patients with MS was 26.4%, 64%, and 9.6%, respectively. The difference in the level of education between the groups based on adherence to the Mediterranean diet was statistically significant. Low adherence to the Mediterranean diet in underweight, normal, and overweight patients was, respectively, 1.31, 1.32, and 2.29 times higher than in obese patients. This increased risk was only significant in overweight patients (P = 0.019). The results revealed that the score of adherence to the Mediterranean diet had no significant relationship with mild (2.86 ± 2.18), moderate (2.76 ± 2.16), and severe (2.70 ± 2.02) levels of disability. CONCLUSION The level of adherence to the Mediterranean diet in Iranian patients with MS was moderate. This level was associated with BMI, such that low adherence to the Mediterranean diet was higher in overweight patients than obese patients.
Collapse
Affiliation(s)
- Somaye Farzinmehr
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samaneh Hosseini
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hoda Kamali
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Poursadeghfard
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Hossein Sharifi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
5
|
Lane J, Ng HS, Poyser C, Lucas RM, Tremlett H. Multiple sclerosis incidence: A systematic review of change over time by geographical region. Mult Scler Relat Disord 2022; 63:103932. [DOI: 10.1016/j.msard.2022.103932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/25/2022] [Accepted: 05/28/2022] [Indexed: 11/28/2022]
|
6
|
Farahmandfard MA, Naghibzadeh-Tahami A, Khanjani N. Ambient air pollution and multiple sclerosis: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:535-544. [PMID: 34821118 DOI: 10.1515/reveh-2020-0079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/09/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Some studies have shown that environmental risk factors, including air pollution, might be related to the incidence or recurrence of multiple sclerosis (MS). This systematic review was conducted to investigate the relation between air pollution and MS. METHODS A systematic search was conducted in PubMed, Scopus, Science Direct, Embase, and Web of Science; until January 2020 with no restrictions. The search strategy was conducted with air pollution key words such as CO, PM2.5, PM10, SO2, and NO2, for exposure and the key word "Multiple sclerosis" as the outcome. RESULTS Eventually, after applying the inclusion and exclusion criteria, 17 articles were included. The methodologies and outcomes reported were heterogeneous and different metrics had been used in the results; therefore conducting a meta-analysis was not possible. Eight studies had analyzed the relation between particulate matter (PM) and the prevalence or relapse of MS and had observed a significant relation. NO2 and NOx were associated with recurrence or prevalence of MS in three studies. But, in three cohort studies, no association was observed between air pollution and recurrence or occurrence of MS. CONCLUSIONS The results of this systematic review show that outdoor air pollution, especially PM and nitrogen oxides might be related to the prevalence or relapse of MS.
Collapse
Affiliation(s)
- Mohammad Amin Farahmandfard
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Social Determinants of Health Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
7
|
Nabavi SM, Dastoorpoor M, Majdinasab N, Khodadadi N, Khanjani N, Sekhavatpour Z, Zamanian M, Kazemian S, Eftekhari AE, Ashtari F, Abolfazli R, Jalili M, Ghaedi G, Ghalianchi HR. Prevalence of Sexual Dysfunction and Related Risk Factors in Men with Multiple Sclerosis in Iran: A Multicenter Study. Neurol Ther 2021; 10:711-726. [PMID: 34008168 PMCID: PMC8571441 DOI: 10.1007/s40120-021-00257-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/05/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Sexual dysfunction (SD) is a common complaint in patients with multiple sclerosis (MS). The aim of this study was to assess the prevalence of SD and its related risk factors in men with MS in Iran. METHODS In this cross-sectional study, 320 men who had been diagnosed with MS according to the McDonald revised criteria were recruited from January to June 2019, from the north, south, east, west, and central parts of Iran. Patients were assessed using the Male Sexual Health Questionnaire (MSHQ), International Index of Erectile Function (IIEF), The Multiple Sclerosis Intimacy and Sexuality Questionnaire-(MSISQ 19), Sexual Quality of Life-Men (SQOL-M), and Standard General Health Questionnaire (GHQ). RESULTS Sexual dysfunction, defined as total IIEF score ≤ 45 was present in 114 patients (35.6%). The results of univariate logistic regression showed that there were significant direct relations between age (OR 1.050, 95% CI 1.02-1.08), Expanded Disability Status Scale (EDSS) (OR 1.45, 95% CI 1.24-1.7), duration of MS (OR 1.005, 95% CI 1.002-1.009), MSISQ-19 (OR 1.103, 95% CI 1.078-1.128), GHQ (OR 1.04, 95% CI 1.03-1.06), SQOL-M (OR 0.930, 95% CI 0.914-0.947), smoking (OR 1.941, 95% CI 1.181-3.188), non-MS chronic disease (OR 1.91, 95% CI 1.20-3.04), having a main sexual partner (OR 2.56, 95% CI 1.32-4.94), and significant inverse relations between exercise (OR 0.584, 95% CI 0.364-0.936) and regular sexual activity (OR 0.241, 95% CI 0.15-0.40), with the prevalence of SD. The results of multiple logistic regression indicated that the age, MSISQ-19, and SQOL-M were the only independent predictive factors for SD in these patients. CONCLUSION The prevalence of SD in men with MS in Iran is relatively high. These patients should be screened, diagnosed, and treated for SD and influencing factors.
Collapse
Affiliation(s)
- Seyed Massood Nabavi
- Department of Regenerative Biomedicine, Royan Institute for Stem Cell Biology and Technology, ACCR, Tehran, Iran
- Department of Brain and Cognition, Royan Institute for Stem Cell Biology and Technology, ACCR, Tehran, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Nastaran Majdinasab
- Department of Neurology, School of Medicine, Musculoskeletal Rehabilitation Research Center, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Neurology Research Center, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Sekhavatpour
- Department of Anesthesiology, School of Allied Medical Sciences, Dezful University of Medical Sciences, Dezful, Iran
| | - Maryam Zamanian
- Department of Health, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Sasan Kazemian
- Department of Regenerative Biomedicine, Royan Institute for Stem Cell Biology and Technology, ACCR, Tehran, Iran
| | - Amir Ebrahim Eftekhari
- Department of Regenerative Biomedicine, Royan Institute for Stem Cell Biology and Technology, ACCR, Tehran, Iran
| | - Fereshteh Ashtari
- Department of Neurology, School of Medicine, Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Abolfazli
- Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Jalili
- Schools of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Gholamhossein Ghaedi
- School of Medicine, Neurophysiology Research Center, Shahed University, Tehran, Iran
| | | |
Collapse
|
8
|
Mirmosayyeb O, Shaygannejad V, Bagherieh S, Hosseinabadi AM, Ghajarzadeh M. Prevalence of multiple sclerosis (MS) in Iran: a systematic review and meta-analysis. Neurol Sci 2021; 43:233-241. [PMID: 34787755 DOI: 10.1007/s10072-021-05750-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prevalence of multiple sclerosis (MS) is increasing world-wide. Iran is not exception. As the prevalence reported differently in various provinces, we designed this systematic review and meta-analysis to estimate pooled prevalence of MS in Iran. METHODS Two researchers systematically searched Scientific Information Database (SID), PubMed, Scopus, EMBASE, Web of Science, and google scholar. They also searched references of the included studies, and conference abstracts which were published up to April 2021. The search strategy included the MeSH and text words as ((((Multiple Sclerosis OR Sclerosis, Multiple) OR Sclerosis, Disseminated) OR Dis-seminated Sclerosis) OR MS (Multiple Sclerosis)) OR Multiple Sclerosis, Acute Fulminating)) AND (prevalence OR prevalences OR period prevalence OR prevalence, period OR point prevalence OR point prevalences OR prevalence, point) AND (Iran OR Islamic Republic of Iran)))). RESULTS The literature search revealed 2817 articles, after deleting duplicates 2184 remained. For the systematic review, 34 studies were included. The prevalence is highest in Tehran and lowest in Khuzestan and Sistan-Baluchestan provinces. The pooled prevalence was 0.001 (95% CI: 0.000-0.001) (I2=0, P<0.001). CONCLUSION The results of this study show that the pooled prevalence of MS in Iran is 100 in 100,000 which is high. The prevalence in provinces increases dramatically.
Collapse
Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Bagherieh
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Mahdi Hosseinabadi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Ghajarzadeh
- Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
9
|
Koch-Henriksen N, Magyari M. Apparent changes in the epidemiology and severity of multiple sclerosis. Nat Rev Neurol 2021; 17:676-688. [PMID: 34584250 DOI: 10.1038/s41582-021-00556-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 02/08/2023]
Abstract
Multiple sclerosis (MS) is an immunological disease that causes acute inflammatory lesions and chronic inflammation in the CNS, leading to tissue damage and disability. As awareness of MS has increased and options for therapy have come into use, a large amount of epidemiological data have been collected, enabling studies of changes in incidence and disease course over time. Overall, these data seem to indicate that the incidence of MS has increased, but the course of the disease has become milder, particularly in the 25 years since the first disease-modifying therapies (DMTs) became available. A clear understanding of these trends and the reasons for them is important for understanding the factors that influence the development and progression of MS, and for clinical management with respect to prevention and treatment decisions. In this Review, we consider the evidence for changes in the epidemiology of MS, focusing on trends in the incidence of the disease over time and trends in the disease severity. In addition, we discuss the factors influencing these trends, including refinement of diagnostic criteria and improvements in health-care systems that have increased diagnosis in people with mild disease, and the introduction and improvement of DMT.
Collapse
Affiliation(s)
- Nils Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. .,The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Melinda Magyari
- The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
10
|
Abdollahpour I, Nedjat S, Almasi-Hashiani A, Nazemipour M, Mansournia MA, Luque-Fernandez MA. Estimating the Marginal Causal Effect and Potential Impact of Waterpipe Smoking on Risk of Multiple Sclerosis Using the Targeted Maximum Likelihood Estimation Method: A Large, Population-Based Incident Case-Control Study. Am J Epidemiol 2021; 190:1332-1340. [PMID: 33576427 DOI: 10.1093/aje/kwab036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 12/11/2022] Open
Abstract
There are few if any reports regarding the role of lifetime waterpipe smoking in the etiology of multiple sclerosis (MS). In a population-based incident case-control study conducted in Tehran, Iran, we investigated the association between waterpipe smoking and MS, adjusted for confounders. Cases (n = 547) were patients aged 15-50 years identified from the Iranian Multiple Sclerosis Society between 2013 and 2015. Population-based controls (n = 1,057) were persons aged 15-50 years recruited through random digit telephone dialing. A doubly robust estimation method, the targeted maximum likelihood estimator (TMLE), was used to estimate the marginal risk ratio and odds ratio for the association between waterpipe smoking and MS. The estimated risk ratio and odds ratio were both 1.70 (95% confidence interval: 1.34, 2.17). The population attributable fraction was 21.4% (95% confidence interval: 4.0, 38.8). Subject to the limitations of case-control studies in interpreting associations causally, these results suggest that waterpipe use, or strongly related but undetermined factors, increases the risk of MS. Further epidemiologic studies, including nested case-control studies, are needed to confirm these findings.
Collapse
|
11
|
Forouhari A, Taheri G, Salari M, Moosazadeh M, Etemadifar M. Multiple sclerosis epidemiology in Asia and Oceania; A systematic review and meta-analysis. Mult Scler Relat Disord 2021; 54:103119. [PMID: 34247103 DOI: 10.1016/j.msard.2021.103119] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory demyelinating CNS disease and the most common neurological immune-mediated disorder. Due to its progressive format, it affects patients' quality of life (QoL) significantly. This study aimed to evaluate epidemiologic parameters of MS in the Asia and Oceania continents. METHODS A comprehensive literature search on October 1st, 2020, was performed in PubMed, Scopus, and Web of Science to retrieve original population-based studies on MS epidemiology in the Asian and Oceanian countries, published between January 1st, 1985 and October 1st, 2020. The designed search strategy was repeated for each country, and the relevant referenced articles were added to our database. A random-effect model was used to combine the epidemiological estimates, and subgroup analysis was also performed by continent, region, and country, when possible. Meta-regression analysis was done to evaluate the effects of Human Developmental Index (HDI), latitude, and study period on the epidemiologic parameters. RESULTS A total of 3,109 publications were found, of which 89 articles met the eligibility criteria and were included for data extraction. These articles provided data on prevalence, incidence, and mean age at disease onset in 18 countries in Asia and Oceania, including Iran, Turkey, Cyprus, Kuwait, Saudi Arabia, Qatar, UAE, Jordan, Israel, India, Malaysia, China, Hong Kong, Taiwan, Republic of Korea, Japan, Australia, and New Zealand. The pooled total prevalence, incidence, and mean age of onset in Asia and Oceania were 37.89/100000 (95% CI: 35.65 - 40.142), 2.40/100000 (95% CI: 2.22 - 2.58), and 28.21 (95% CI: 27.55 - 28.88), respectively. MS prevalence and incidence in the female gender (68.7/100000 and 4.42/100000, respectively) were infinitely higher than in the male gender (24.52/100000 and 2.06/100000, respectively). Our subgroup analysis showed that MS was much more prevalent in Australia and West Asia among the studied area. The meta-regression showed that the total incidence decreased with an increase in the HDI, and the total prevalence in Asia increased with increasing latitude gradients. Also, the study period had a positive effect on the total prevalence and incidence in Asia and Oceania. CONCLUSION MS prevalence and incidence have increased in recent decades. This study highlights the need for further studies to elucidate MS's geographical and temporal variations' exact etiologies.
Collapse
Affiliation(s)
- Ali Forouhari
- Alzahra research center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ghazale Taheri
- Alzahra research center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehri Salari
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Etemadifar
- Department of Neurology Medical School, Alzahra research center, Isfahan University of Medical Science, Isfahan, Iran
| |
Collapse
|
12
|
Mobasheri F, Fararouei M, Hasanzadeh J, Jaberi AR. 18-year temporal trend of multiple sclerosis in southern Iran. Mult Scler Relat Disord 2021; 52:103018. [PMID: 34023774 DOI: 10.1016/j.msard.2021.103018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/03/2021] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) imposes significant burdens on patients, their families, and national healthcare systems particularly when there is a resource constraint. Proper prioritization and resource allocation are therefore essential for any effective disease management. Accordingly, we sought to assess the temporal profile of MS incidence over the past two decades in southeast Iran. METHODS A longitudinal design was employed using data from the Iranian multiple sclerosis registry system from March 2001 to March 2019 (n=6034). Annual age-standardized incidence rates of MS (cases of clinically isolated syndrome were also included) were calculated and the trend of incidence from 2001 to 2018 was analyzed. RESULTS The age-adjusted incidence rate of MS raised from 1.72/100,000 in 2001 to 11.29/100,000 in 2018 (average of 18-year incidence rate was 6.30/100,000), indicating a notable rise in the incidence of MS (P-Value<0.001). However, the female to male ratio of 3.62 remained relatively stable during the study period. CONCLUSION Our study suggests that, in Fars province, the incidence of MS has been remarkably rising over the past two decades. We recommend further studies to better understand the determinants of this pattern. Implementing effective policies in lowering the burden of MS is another important step in this regard.
Collapse
Affiliation(s)
- Farzaneh Mobasheri
- Student Research Committee; Shiraz University of medical science, Shiraz; Iran
| | - Mohammad Fararouei
- Professor, HIV/AIDS Research Center; Shiraz University of Medical Sciences; Iran.
| | - Jafar Hasanzadeh
- Professor, Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rahimi Jaberi
- Assistant Professor, Clinical neurology research center, non-communicable disease research center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
13
|
Gonçalves MVM, Siquineli F, Ribas FD, Longo AL, Amaral CHD, Chikota EM, Wille PR, Eboni ÁCB, Liberato RB, Morales RR, Becker J, Lana-Peixoto MA. Prevalence of multiple sclerosis in key cities of Brazil. A study in Joinville, Southern Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:122-126. [PMID: 33759978 DOI: 10.1590/0004-282x-anp-2020-0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/15/2020] [Indexed: 02/10/2023]
Abstract
BACKGROUND The Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS) has launched an initiative to determine the prevalence of multiple sclerosis (MS) in Brazil, based on key cities deemed representative of their regions in terms of demographic and environmental features. OBJECTIVE To investigate the prevalence rate of MS in Joinville. METHODS We reviewed the medical records of all patients who lived in Joinville and met the 2010 McDonald's diagnostic criteria revised for MS on the prevalence day (March 11, 2016). Potential MS patients included individuals treated by all practicing neurologists in the city and the ones found in patients' association and the database of the Municipal Department of Health. Advertisements about the survey were also broadcast on radio and television. Patients who were not living in Joinville on the prevalence day were excluded. All potential MS patients were invited to an in-person diagnostic review, carried out by a panel of experienced neurologists with special expertise in MS on March 11, 2016. RESULTS The MS prevalence rate was 13.5 per 100,000 inhabitants (95% confidence interval [95%CI] 12.9-14.0/100,000). A total of 51 (66.2%) participants were females, and 26 (33.7%) were males (female to male ratio=1.9:1). Out of the 77 patients, 73 (94.8%) were Caucasians, and four (5.1%) were mixed-race. CONCLUSIONS Despite its latitude location and European colonization, the prevalence rate was below expectation. The intense internal migration from regions with lower MS prevalence rates to Joinville may have played a role in attenuating the increased risk of MS associated with latitude gradient and European ancestry. Prevalence studies in other cities from Southern Brazil with no significant internal migration and taking part in this broad project may clarify this issue.
Collapse
Affiliation(s)
| | - Fábio Siquineli
- Universidade de Blumenau, Departamento de Neurologia, Blumenau SC, Brazil
| | | | | | | | | | - Paulo Roberto Wille
- Universidade da Região de Joinville, Departamento de Neurologia, Joinville SC, Brazil
| | | | | | - Rogério Rizo Morales
- Universidade Federal de Uberlândia, Departamento de Neurologia, Uberlândia MG, Brazil
| | - Jefferson Becker
- Pontifícia Universidade Católica do Rio Grande do Sul, Instituto do Cérebro (INSCER), Programa de Neuroimunologia, Porto Alegre RS, Brazil
| | - Marco Aurélio Lana-Peixoto
- Universidade Federal de Minas Gerais, Centro de Investigação em Esclerose Múltipla (CIEM), Belo Horizonte MG, Brazil
| |
Collapse
|
14
|
Hosseinzadeh A, Sedighi B, Kermanchi J, Heidari M, Haghdoost AA. Is the sharp increasing trend of multiple sclerosis incidence real in Iran? BMC Neurol 2021; 21:7. [PMID: 33407243 PMCID: PMC7789321 DOI: 10.1186/s12883-020-02031-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 12/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some epidemiologic studies have reported a sharp increase in multiple sclerosis (MS) incidence in different provinces in Iran. This report aimed to investigate more closely the increasing trend of MS incidence in the past 10 years in Iran. METHODS In this longitudinal study, the data for all MS patients meeting the McDonald criteria were obtained from a national registry, coordinated by the Ministry of Health (MOH). Joinpoint (JP) regression was used for time trend analysis of MS incidence and determine the optimal number of significant joinpoints. Finally, an annual percentage change (APC) in MS incidence for each segment of the trend line was estimated with 95% confidence interval. RESULTS The mean age of the patients and the mean annual incidence rate of MS were 30.9 ± 1.1 and 5.3 ± 1.9 per 100,000 population, respectively. The overall incidence rate of MS had increased significantly from 2.14 in 2006 to its peak (7.5) in 2014, per 100,000 population (APC = 12%, P < 0.001). The first JP was observed in 2011 in both male and female groups. The overall APC in the first segment was 22.6% (17.2-28.2%, p < 0.01). Besides, the corresponding APC values for males and females were 22.1% (14.7-30%, p < 0.01) and 22.5% (17.5-27.8%, p < 0.01), respectively. After 2011, the MS incidence underwent a more or less decreasing trend in both genders. CONCLUSION Contrary to previous studies, the MS incidence trend in Iran was rising just before 2011, and in the recent decade, Iran has a stable rate of MS cases.
Collapse
Affiliation(s)
- Ali Hosseinzadeh
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Behnaz Sedighi
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Jamshid Kermanchi
- Deputy of Curative Affairs, Ministry of Health and Medical Education (MOHME, Tehran, Iran
| | - Mohammad Heidari
- Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
15
|
Rafiee F, Tarjoman T, Moghadasi AN, Sahraian MA, Azimi A, Rezaeimanesh N, Eskandarieh S. Stressful life events, socioeconomic status, and the risk of neuromyelitis optica spectrum disorder: A population-based case-control study. Mult Scler Relat Disord 2020; 46:102544. [DOI: 10.1016/j.msard.2020.102544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022]
|
16
|
Molazadeh N, Mohebi F, Altafi D, Sahraian MA. Prevalence and incidence of multiple sclerosis in Ardabil, Northwest of Iran. Mult Scler Relat Disord 2020; 47:102605. [PMID: 33217696 DOI: 10.1016/j.msard.2020.102605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) epidemiology is studies in many populations; however, studying populations with unique characteristics could provide opportunities to deepen the understanding of the underlying reason of the disease. In this regard, we aimed to study the epidemiology of MS in Ardabil, a province in northwest Iran, where the majority are of Iranian Azerbaijanis. METHOD A retrospective population-based study was conducted from 2008 to 2018 in Ardabil, based on the data of Iran's Ministry Of Health. Collected information includes sex, age, age at disease onset, education and type of MS. We used t-test to compare means and chi-square test to analyze the association among variables. RESULTS The total number of patients was 760 with 533 (70.13%) females and 227 (29.87%) males. The crude prevalence was 59.37 per 100,000 in 2018 (95% CI: 55.31, 63.73). The crude incidence rate was 7.65 per 100,000 in 2018 (95% CI: 6.28, 9.32). The most frequent educational level was high school diploma (38.36%). The relapsing-remitting (RR) form was the most frequent type of MS (48.16%). The F/M ratio was 2.92:1 and the mean onset age was 33.14 (95% CI: 31.56, 34.72) in 2018, significantly higher in males (P value= 0.01). CONCLUSION Ardabil is a medium risk zone of MS. The different ethnicity of its population, climate and environmental features, may explain the factors modulating the risk of MS in similar areas and present windows of opportunity to understand the causes of MS.
Collapse
Affiliation(s)
- Negar Molazadeh
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Davar Altafi
- Department of Neurology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
17
|
Iljicsov A, Milanovich D, Ajtay A, Oberfrank F, Bálint M, Dobi B, Bereczki D, Simó M. Incidence and prevalence of multiple sclerosis in Hungary based on record linkage of nationwide multiple healthcare administrative data. PLoS One 2020; 15:e0236432. [PMID: 32716953 PMCID: PMC7384662 DOI: 10.1371/journal.pone.0236432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/06/2020] [Indexed: 01/21/2023] Open
Abstract
Objectives As there were only regional studies in Hungary about the prevalence of multiple sclerosis (MS), we aimed to estimate its epidemiological features using data of Hungary’s single-payer health insurance system. Methods Pseudonymized database of claims reported by hospitals and outpatient services between 2004–2016 was analyzed and linked with an independent database of outpatient pharmacy refills between 2010–2016. We established an administrative case definition of MS and validated it on medical records of 309 consecutive patients. A subject was defined as MS-patient if received MS diagnosis (International Classification of Diseases, 10th edition, code G35) on three or more occasions at least in 2 calendar years and at least once documented by a neurologist. Patients were counted as incident cases in the year of the first submitted claim for MS. We allowed a 6-year-long run-in period, so only data between 2010–2015 are discussed. Results Sensitivity of the administrative case definition turned out to be 99%, while specificity was >99%. Crude prevalence of MS has increased from 109.3/100,000 in 2010 to 130.8/100,000 in 2015 (p-value = 0.000003). Crude incidence declined from 7.1/100,000 (2010) to 5.4/100,000 (2015) (p-value = 0.018). Direct standardization − based on European standard population and results of nationwide Hungarian census of 2011 − revealed that age standardized prevalence was 105.2/100,000 (2010), which has grown to 127.2/100,000 (2015) (p-value = 0.000001). Age standardized incidence rate declined from 6.7/100,000 (2010) to 5.1/100,000 (2015) (p-value = 0.016). The ratio of MS-patients receiving ≥1 prescription for disease modifying treatment increased from 0.19 (2010) to 0.29 (2015) (p-value = 0.0051). The female/male ratio of prevalent cases remained 2.6. Discussion The prevalence of MS in Hungary is higher than previously reported, the incidence rate is moderate. The prevalence is rising, the incidence rate shows decline. The proportion of patients receiving disease modifying treatment grows but was still around 30% in 2015.
Collapse
Affiliation(s)
- Anna Iljicsov
- Department of Neurology, Semmelweis University, Budapest, Hungary
- * E-mail: (DB); (AI)
| | | | - András Ajtay
- Department of Neurology, Semmelweis University, Budapest, Hungary
- MTA-SE Neuroepidemiological Research Group, Budapest, Hungary
| | | | - Mónika Bálint
- Centre for Economic and Regional Studies, Budapest, Hungary
| | - Balázs Dobi
- Department of Probability Theory and Statistics, Eötvös Loránd University, Budapest, Hungary
| | - Dániel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
- MTA-SE Neuroepidemiological Research Group, Budapest, Hungary
- * E-mail: (DB); (AI)
| | - Magdolna Simó
- Department of Neurology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
18
|
Age and sex-adjusted incidence and yearly prevalence of multiple sclerosis (MS) in Mazandaran province, Iran: An 11-years study. PLoS One 2020; 15:e0235562. [PMID: 32614900 PMCID: PMC7332002 DOI: 10.1371/journal.pone.0235562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/17/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The incidence rate of MS is a valuable indicator of the recent changes in the risk of this disease, and it is widely implicated for health planning purposes. OBJECTIVES This study aims to determine the MS incidence over the past eleven years in Mazandaran province and to compare it with the other parts of Iran and the world. MATERIALS AND METHODS This retrospective study is conducted in Mazandaran province by using registered data in the files of the patients with their consent. The yearly crude incidence rates, age, and sex-specific incidence rates and directly standardized incidence rates of this population are calculated, and the temporal changes in the incidence rates are analyzed. RESULTS 662 (26%) male patients with the mean (SD) age of 32.6 (9.48) and 1884 (74%) female patients with the mean (SD) age of 31.9 (9.15) are studied. The direct standardized incidence rate of MS was 3.28 in 100.000 in 2008 and reached 4.17 in 100.000 in 2018, and this increase was significant (p<0.05). Also, the yearly prevalence of MS increased from 24.4 to 72.5 in this period. CONCLUSIONS The MS incidence has increased in Mazandaran. The potential role of some genetic or environmental factors needs further investigation.
Collapse
|
19
|
Arshi M, Sheybani F, Eghlima M, Shati M, Moghanibashi-Mansourieh A, Moshayyedi M. Group social work intervention enhances the sexual satisfaction of women with Multiple Sclerosis: a randomized controlled trial study. SOCIAL WORK IN HEALTH CARE 2020; 59:322-333. [PMID: 32420825 DOI: 10.1080/00981389.2020.1762148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 04/08/2020] [Accepted: 04/17/2020] [Indexed: 06/11/2023]
Abstract
Sexual problems are among the most common disorders that people with Multiple Sclerosis have to deal with, resulting in decreased sexual satisfaction and quality of life. The study is aimed to investigate the impact of group social work intervention on the sexual satisfaction of women with Multiple Sclerosis. The methodology was a randomized controlled trial and 58 participants recruited (30 for control group and 28 for intervention group). The intervention was based on group social work with an empowerment approach within eight sessions. The average age of the participants was 35.95 ± 6.41 most of whom had high school diploma (62.1%). The findings indicate that, in terms of sexual satisfaction (t = 5.47, Sig = 0.03, df = 56), primary disorders (t = 2.42, Sig = 0.019, df = 56), and tertiary disorders (t = 3.77, Sig = 0.002, df = 56), there is a significant difference between intervention and control groups.
Collapse
Affiliation(s)
- Maliheh Arshi
- Social Work Department, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran
| | - Fahime Sheybani
- Social Work Department, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran
| | - Mostafa Eghlima
- Social Work Department, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran
| | - Mohsen Shati
- Mental Health Research Center, Social Injury Prevention Research Institute, Iran University of Medical Sciences , Tehran, Iran
- Mental Health Research Center, Tehran Institute of Psychiatry-School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences , Tehran, Iran
| | - Amir Moghanibashi-Mansourieh
- Social Work Department, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran
- Training and Research Department, Iran Association of Social Workers , Tehran, Iran
| | - Maryam Moshayyedi
- Social Work Department, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran
| |
Collapse
|
20
|
Abdollahpour I, Nedjat S, Salimi Y, Mansournia MA, Vahid F, Weinstock-Guttman B. The role of dietary antioxidant index and index of nutritional quality in MS onset: finding from an Iranian population-based incident case–control study. Nutr Neurosci 2020; 25:379-386. [DOI: 10.1080/1028415x.2020.1755792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Ibrahim Abdollahpour
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Vahid
- Department of Nutritional Sciences, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| |
Collapse
|
21
|
Baghbanian SM, Cheraghmakani H, HabibiSaravi R, Azar A, Ghasemihamedani F. Does the multiple sclerosis (MS) map need to change again? An update of MS prevalence in Mazandaran province of Iran in 2018. BMC Neurol 2020; 20:52. [PMID: 32050931 PMCID: PMC7017621 DOI: 10.1186/s12883-020-1618-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 01/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Information of Previous studies on the prevalence of MS, including our study conducted 12 years ago, used to shape global prevalence map of MS. According to those results, Iran placed in medium-prevalence MS region in the world Atlas of MS 2013.This study aimed to investigate the prevalence of MS in Mazandaran province after 12 years and the need for possible changes in the global map of the prevalence of MS. METHODS We included all MS patients living in Mazandaran province in 2018 in this descriptive cross-sectional study. We updated our pre-existing registration questionnaires which included demographic information and medical data of MS patients by interview. We obtained the demographic profile of Mazandaran province from the most recent census in 2016 and the National Civil Registry of the Mazandaran province for calculating prevalence of MS. RESULTS The total number of MS patients in Mazandaran was 2418 (25.8% male and 74.2% female) with a female to male ratio of 2.9. Based on the local population of 3,332,556, (50.4% male and 49.6% female), this study showed a prevalence of 72.5 per 100,000 for MS in this region. The prevalence of this disease by gender was 37.1 per 100,000 for men and 108.5 per 100,000 for women. The mean (SD) age of the patients at the time of the study was 38.5 (10.1) years with a minimum of 15 and a maximum of 75 years. The most common type of MS was Relapsing-Remitting MS with 86%. CONCLUSIONS All recent studies showed significant upward trend in the prevalence of MS around the world. Based on the results of our study and many other studies in Iran, the Atlas of MS prevalence map needs to be update. Iran's status should be changed to the high-prevalence of MS in the new Atlas. Due to the increasing prevalence of MS, we suggest an adjustment in the Global MS Prevalence Scale.
Collapse
Affiliation(s)
- Seyed Mohammad Baghbanian
- Multiple Sclerosis Fellowship, Neurology Department, Boualicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Cheraghmakani
- Neurology Department, Boualicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza HabibiSaravi
- Multiple Sclerosis Clinic, Boualicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Arash Azar
- School of Public health, Faculty of Medicine, University of Sydney, Sydney, Australia
| | | |
Collapse
|
22
|
Etemadifar M, Nikanpour Y, Neshatfar A, Mansourian M, Fitzgerald S. Incidence and prevalence of multiple sclerosis in persian gulf area: A systematic review and meta-analysis. Mult Scler Relat Disord 2020; 40:101959. [PMID: 31991397 DOI: 10.1016/j.msard.2020.101959] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 01/08/2020] [Accepted: 01/18/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND There is an unapprehended diversity in the epidemiology of multiple sclerosis (MS) in different geographical regions. In this study, for the first time, we systematically review the studies estimating the incidence and/or prevalence of MS in the Persian Gulf area. The goal is to obtain the overall incidence and prevalence of MS and elucidate the reasons for the geographical variation. METHODS A comprehensive literature search was carried out using MEDLINE and EMBASE through articles published between January 1985 and December 2018 on MS epidemiology in Persian Gulf countries including Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Search terms included 'Multiple sclerosis', 'Incidence', 'Prevalence', 'Epidemiology', 'Persian Gulf', 'Arabian Gulf' and name of each country. Only full-text articles published in English were included. All abstracts were considered and two trained reviewers evaluated the study quality using an assessment tool specifically designed for this study. RESULTS 39 studies met the inclusion criteria. The mean age at disease onset varied in each country and the pooled mean age of onset was 23.11. The overall pooled MS incidence was 5.03/100,000 person-years (95% CI: 0.04 - 10.02). Prevalence was 39.31/100,000 (95% CI: 29.12 - 49.50) and the result of the meta-regression method showed that prevalence increased by 2.3% per year between 1985-2018 (p = 0.04). Quality scores ranged from 4/7 to 8/8. CONCLUSION The prevalence and incidence of MS in the Persian Gulf region has gone through significant changes during the past decades. This study highlights the need for future studies of MS prevalence and incidence, which will further elucidate the possible etiologies leading to periodical and geographical variations in MS incidence.
Collapse
Affiliation(s)
- Masoud Etemadifar
- Department of Functional Neurosurgery Medical School, Isfahan University of Medical Science, Isfahan, Iran
| | - Yalda Nikanpour
- Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Amir Neshatfar
- Department of Neurology, Louisiana State University Health Science Center, Shreveport, USA
| | - Marjan Mansourian
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sean Fitzgerald
- Department of Physiology, National University of Ireland Galway, Galway, Ireland
| |
Collapse
|
23
|
Moghbeli M. Genetic and Molecular Biology of Multiple Sclerosis Among Iranian Patients: An Overview. Cell Mol Neurobiol 2019; 40:65-85. [PMID: 31482432 DOI: 10.1007/s10571-019-00731-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/24/2019] [Indexed: 12/16/2022]
Abstract
Multiple sclerosis (MS) is one if the common types of autoimmune disorders in developed countries. Various environmental and genetic factors are associated with initiation and progression of MS. It is believed that the life style changes can be one of the main environmental risk factors. The environmental factors are widely studied and reported, whereas minority of reports have considered the role of genetic factors in biology of MS. Although Iran is a low-risk country in the case of MS prevalence, it has been shown that there was a dramatically rising trend of MS prevalence among Iranian population during recent decades. Therefore, it is required to assess the probable MS risk factors in Iran. In the present study, we summarized all of the reported genes until now which have been associated with MS susceptibility among Iranian patients. To clarify the probable molecular biology of MS progression, we categorized these reported genes based on their cellular functions. This review paves the way of introducing a specific population-based diagnostic panel of genetic markers among the Iranian population for the first time in the world.
Collapse
Affiliation(s)
- Meysam Moghbeli
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
24
|
Hosseinzadeh A, Baneshi MR, Sedighi B, Kermanchi J, Haghdoost AA. Incidence of multiple sclerosis in Iran: a nationwide, population-based study. Public Health 2019; 175:138-144. [PMID: 31476710 DOI: 10.1016/j.puhe.2019.07.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/22/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The incidence of multiple sclerosis (MS) is not well known in Iran. This study was conducted to estimate the trends in annual MS incidence in Iran from March 21, 2010, to March 20, 2016. STUDY DESIGN Longitudinal study. METHODS In this longitudinal study, data for all MS patients fulfilling McDonald criteria were obtained from a national registry, coordinated by the Ministry of Health (MOH). In Iran, all MS patients are eligible to receive public care and treatment services based on their records in this registry, and thus nearly all MS patients are registered in this database. The annual incidence rates were calculated based on year of diagnosis and were standardized using the World Health Organization (2000-2025) population as a standard. RESULTS In this registry, 36,287 (8202 [22.6%] males and 28,085 [77.4%] females) confirmed MS cases were registered by the MOH between 2010 and 2016. The female-to-male ratio was 3.11. The mean age of patients was 31.6 ± 0.9 years at the time of diagnosis. It was 31.3 ± 0.8 and 32.3 ± 0.9 for females and males, respectively. Overall incidence rate was 6.7/100,000 population (95% confidence interval [CI]: 6.2-7.2); 10.5 and 3.0 in females and males, respectively. The age-adjusted incidence rates increased significantly from 4.4 (95% CI: 4.3-4.6) in 2010 to 5.8 (95% CI: 5.7-6.0) in 2016, with its peak at 6.5 (95% CI: 6.3-6.6) in 2014. CONCLUSIONS This study revealed that Iran is a high-risk area for MS disease and that MS incidence and female-to-male ratio are more or less comparable with the dominant patterns in developed countries. Also, this study showed that the incidence trend of MS in Iran is similar to regional and global observed patterns.
Collapse
Affiliation(s)
- A Hosseinzadeh
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - M R Baneshi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - B Sedighi
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - J Kermanchi
- Deputy of Curative Affairs, Ministry of Health and Medical Education (MOHME), Tehran, Iran
| | - A A Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| |
Collapse
|
25
|
Eskandarieh S, Sahraiain MA, Molazadeh N, Moghadasi AN. Pediatric multiple sclerosis and its familial recurrence: A population based study (1999-2017). Mult Scler Relat Disord 2019; 36:101377. [PMID: 31473489 DOI: 10.1016/j.msard.2019.101377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/20/2019] [Accepted: 08/26/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND The Pediatric onset multiple sclerosis (POMS) prevalence is increasing worldwide accounting for around 3 to 10% of MS cases. The risk of POMS is supposed to reflect a complex interaction between environmental and genetic risk factors that may occur during the childhood, adolescent, or post-pubertal years. OBJECTIVE The present study aimed at estimating the prevalence of POMS and assessing the epidemiology of familial recurrence of POMS in Tehran. METHOD A retrospective population based cross-sectional study was designed from 1999 to 2017. The baseline characteristic information was collected from MS patient's ≤18 years old (y/o). Pearson's chi-square test and logistic regression were used to analyze the relationship among variables and estimate the odds ratio (OR) via SPSS software, version 23. RESULTS A total of 1937 POMS patients (77.80% female and 22.20% male patients) participated in the study. The point prevalence of POMS was 16.20 per 100,000 populations in 2017. Mean age at disease onset was 15.96 ± 2.28 y/o. The female to male ratio was 2.02:1 in pre-pubertal cases (3-12 y/o), but it increased to 3.69:1 in 13-18 y/o age groups (P value = 0.001, OR = 1.82; 95% CI = 1.27-2.26). There were 288 (14.9%) cases with positive familial history of MS. The strongest association between MS risk and positive familial history was observed in second degree relatives who presented MS (P value = 0.046, OR = 1.74; 95%CI = 1.01-3.01). A significant association was observed among maternal second degree relatives with POMS (P value = 0.018, OR = 2.27; 95%CI = 1.15-4.47). CONCLUSION In comparison to other large studies, the prevalence of POMS was high in the data collected from Tehran. POMS risk is higher among females and the sex ratio increases after puberty. We found a significant association between POMS risk and familial history in maternal second degree relatives. Further studies of POMS epidemiology might yield greater understanding of the natural history of this disease.
Collapse
Affiliation(s)
- Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Ali Sahraiain
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Molazadeh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
26
|
Abdollahpour I, Sormani MP, Nedjat S, Mansournia MA, van der Mei I. The role of nutritional factors during adolescence in multiple sclerosis onset: a population-based incident case-control study. Nutr Neurosci 2019; 24:500-507. [PMID: 31362644 DOI: 10.1080/1028415x.2019.1647689] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The potential role of nutritional factors in multiple sclerosis (MS) etiology is not clearly understood. The authors investigated the association between dietary intake during adolescence with MS. DESIGN, SETTING AND PARTICIPANTS This was a population-based incident case-control study in Iran with 547 incident cases and 1057 general population controls (7/8/2013-17/2/2015). Logistic regression was used to test differences in dietary intake between cases and controls adjusted for confounders. RESULTS We found that a higher dietary consumption during adolescence of fresh fish, canned tuna, poultry, cheese, yogurt, butter, fruit, vegetables and a number of dietary supplements were associated with a significantly reduced risk of MS, while red meat, shrimp, and margarine were not associated with MS. Fresh fish had a dose-response association of 0.71 (0.58-0.88) per category increase, and consuming >0.5 serves of canned tuna fish per week had an OR of 0.72 (0.56-0.90); fruit intake had an OR of 0.82 (0.71-0.94) per category increase and cheese consumption an OR of 0.78 (0.67-0.91) per category increase. CONCLUSIONS We identified that a higher intake of a number of food groups generally viewed as healthy were associated with a reduced risk of MS. A healthier diet during adolescence may be protective of developing MS.
Collapse
Affiliation(s)
- Ibrahim Abdollahpour
- Neuroscience research center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maria Pia Sormani
- Department of Health Sciences, University of Genova, Genova, Italy.,IRCCS Ospedale Policlinico San artino, Genova, Italy
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Knowledge Utilization Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ingrid van der Mei
- Ingrid van der Mei: Menzies Institute for Medical Research, University of Tasmania, Australia
| |
Collapse
|
27
|
Mahmudi L, Moslemirad M, Dabestani B, Shohani M, Azami M. Clinical and demographic features in Iranian multiple sclerosis patients: a systematic review and meta-analysis. FUTURE NEUROLOGY 2019. [DOI: 10.2217/fnl-2018-0025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: This study was conducted to determine the clinical and demographic features in Iranian multiple sclerosis (MS) patients including clinical courses, positive MS family history, disability and age of disease onset. Materials & methods: All stages of the study were reported according to the PRISMA guidelines. A systematic review of published literature in Persian and English journals with a comprehensive search was conducted on English international databases including Scopus, PubMed/Medline, Cochrane Library, Science Direct, Web of Science, Embase, PsycINFO, as well as the Google Scholar search engine and national databases. Results: The prevalence of clinical courses of relapsing remitting, primary progressive, secondary progressive and relapsing progressive in Iranian patients with MS was 77.1% (95% CI: 72.2–81.3), 6.2% (95% CI: 4.1–9.2), 9.5% (95% CI: 6.8–13.1) and 0.4% (95% CI: 0.2–0.8), respectively. Positive family history of MS in Iranian MS patients was 8.9% (95% CI: 6.9–11.4). The mean age of disease onset was 28.9 years (95% CI: 27.8–30.1). Conclusion: The results of this meta-analysis in an Iranian population can provide useful information for neurologists and healthcare.
Collapse
Affiliation(s)
- Leily Mahmudi
- School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Moslem Moslemirad
- School of Nursing & Midwifery, Yasuj University of Medical Science, Yasuj, Iran
| | - Bafrin Dabestani
- Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Shohani
- Department of Nursing, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Milad Azami
- School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| |
Collapse
|
28
|
Ghajarzadeh M, Keshtkar AA, Azimi A, Sahraian MA, Mohammadifar M, Ramagopalan SV. The Effect of Vitamin D Supplements on Clinical and Para-Clinical Outcomes in Patients With Multiple Sclerosis: Protocol for a Systematic Review. JMIR Res Protoc 2019; 8:e12045. [PMID: 31008714 PMCID: PMC6658286 DOI: 10.2196/12045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 11/26/2022] Open
Abstract
Background Multiple sclerosis (MS) is an inflammatory disease, which has a wide range of effects on patients. There are controversies regarding the role of vitamin D in clinical and laboratory improvements in MS patients. Objective The aim of this systematic review protocol is to evaluate the efficacy of vitamin D supplements on relapse rate, gadolinium-enhancing lesions of magnetic resonance imaging (MRI), and cytokine profiles. Methods We will search PubMed, Scopus, EMBASE, CINAHL, Web of Science, Ovid, ProQuest, American College of Physicians Journal Club database, Health Technology Assessment Database (The Cochrane Collaboration), and National Health System Economic Evaluation Database (The Cochrane Collaboration) and gray literature including reference of included studies and conference abstracts. Clinical trials reporting the effect of any doses of vitamin D on relapse rate, gadolinium-enhancing lesions of MRI, and cytokine profiles will be included. In total, 2 independent researchers will independently assess the studies, extract data, and evaluate the quality of primary studies. Results This systematic review was started in September 2017 and the process is continuing. The included articles are evaluated and researchers are going to extract the data. Conclusions To our knowledge, this will be the first comprehensive systematic review aiming to assess the effect of vitamin D supplements on clinical and para-clinical outcomes in patients with multiple sclerosis. International Registered Report Identifier (IRRID) DERR1-10.2196/12045
Collapse
Affiliation(s)
- Mahsa Ghajarzadeh
- Universal Council of Epidemiology, Universal Scientific Education and Research Network, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Abbas Ali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Amirreza Azimi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mehdi Mohammadifar
- Department of Radiology, Zanjan University of Medical Sciences, Zanjan, Islamic Republic of Iran
| | | |
Collapse
|
29
|
Azami M, YektaKooshali MH, Shohani M, Khorshidi A, Mahmudi L. Epidemiology of multiple sclerosis in Iran: A systematic review and meta-analysis. PLoS One 2019; 14:e0214738. [PMID: 30964886 PMCID: PMC6456231 DOI: 10.1371/journal.pone.0214738] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/19/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis. METHOD A systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: CRD42018114491. RESULTS According to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran was estimated 29.3/ 100,000 (95%CI: 25.6-33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and 44.8/ 100,000 (95%CI: 36.3-61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8-6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3-61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (p<0.001). CONCLUSIONS The results of this study can provide a general picture of MS epidemiology in Iran. The current meta-analysis showed that the prevalence and incidence of MS in Iran is high and is rising over time.
Collapse
Affiliation(s)
- Milad Azami
- Student Research Committee, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Hossein YektaKooshali
- Student Research Committee, School of Nursing, Midwifery and Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoumeh Shohani
- Department of Nursing, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Khorshidi
- Department of Epidemiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Leily Mahmudi
- Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| |
Collapse
|
30
|
Geographic variations of multiple sclerosis in Iran: A population based study. Mult Scler Relat Disord 2019; 28:244-249. [PMID: 30634104 DOI: 10.1016/j.msard.2019.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/22/2018] [Accepted: 01/01/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The epidemiology of Multiple sclerosis (MS) has changed in recent decades. Considering that the incidence and geographical variations of MS is not well known in Iran. The present study was conducted to investigate the incidence of MS and its geographic variations in Iran. METHODS Data from a national registry, coordinated by the Ministry of Health (MOH), were collected for this study. In Iran, all MS patients are eligible to receive care and treatment services based on their records in this registry. Therefore, it seems that the related data are comprehensive with very high coverage, particularly in recent years. In this study, the annual incidence rates were calculated based on year of diagnosis of MS. RESULTS In this registry, 32,633 new cases were recorded between 2011 and 2016. After standardized for age, the mean annual incidence rate was 6.5 per 100,000 populations. It was 10.2 and 2.9 in women and men respectively. This incidence ranged from 1.7 to 12.8 in provincial level, with a higher intensity in the central part of the country. CONCLUSION It seems that the incidence rate of MS and its ratio in females and males are more or less comparable with the dominant patterns in developed countries, although its variation within the country is very considerable.
Collapse
|
31
|
Salimi Kivi M, Jamei-Moghadam M, Khoshlahni H, Heidarzadeh M, Kamran A, Shahabi H. Psychological Changes in Patients With Multiple Sclerosis. JOURNAL OF HOLISTIC NURSING AND MIDWIFERY 2019. [DOI: 10.29252/hnmj.29.1.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
32
|
Abdollahpour I, Nedjat S, Salimi Y, Moradzadeh R, Mansournia MA, Sahraian MA, Shokoohi M. No association between socioeconomic status and risk of multiple sclerosis: A population-based incident case-control study in a developing country. Mult Scler Relat Disord 2018; 25:292-296. [DOI: 10.1016/j.msard.2018.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 12/31/2022]
|
33
|
Abdollahpour I, Nedjat S, Mansournia MA, Eckert S, Weinstock-Guttman B. Infectious exposure, antibiotic use, and multiple sclerosis: A population-based incident case-control study. Acta Neurol Scand 2018; 138:308-314. [PMID: 29740825 DOI: 10.1111/ane.12958] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The existing reports regarding the potential role of infections as well as antibiotic use in multiple sclerosis (MS) etiology are inconclusive. OBJECTIVES We aimed to investigate the association of viral infections as well as antibiotic use and the risk of developing MS. MATERIALS & METHODS This was a population-based incident case-control study of 547 incident cases and 1057 general population controls obtained from 22 municipality areas of Tehran (7/8/2013-17/2/2015). Multiple logistic regression models were used to determine the adjusted associations. RESULTS Overall antibiotic use for ≥14 days during 3 years before the index date, significantly decreased the odds of MS OR 0.69 (95%CI: 0.53-0.91, P = .008). The results were consistent for different types of antibiotics, including penicillin OR 0.50 (95%CI: 0.34-0.75, P = .001) and cephalosporins OR 0.25 (95%CI: 0.12-0.50, P < .001). History of IM was associated with a more than 5fold increased risk of MS OR = 5.7 (95%CI, 1.28-25.37). There was no statistically significant association between any other single or cumulative number of viral infections with subsequent risk of MS (P > .05). CONCLUSIONS Considering the possibility of reverse causation, the results of this large case-control study suggest that use of antibiotics may be associated with a decreased risk of MS. However, viral disease other than infectious mononucleosis was not associated with MS risk.
Collapse
Affiliation(s)
- I. Abdollahpour
- Department of Epidemiology; School of Public Health; Arak University of Medical Sciences; Arak Iran
| | - S. Nedjat
- Department of Epidemiology and Biostatistics; School of Public Health; Knowledge Utilization Research Center; Tehran University of Medical Sciences; Tehran Iran
| | - M. A. Mansournia
- Department of Epidemiology and Biostatistics; School of Public Health; Tehran University of Medical Sciences; Tehran Iran
| | - S. Eckert
- University at Buffalo; Jacobs School of Medicine and Biomedical Sciences; Buffalo NY USA
| | - B. Weinstock-Guttman
- Neurology; Jacobs School of Medicine and Biomedical Science; University of Buffalo; Buffalo NY USA
| |
Collapse
|
34
|
Abdollahpour I, Nedjat S, Mansournia MA, Eckert S, Weinstock-Guttman B. Stress-full life events and multiple sclerosis: A population-based incident case-control study. Mult Scler Relat Disord 2018; 26:168-172. [PMID: 30268037 DOI: 10.1016/j.msard.2018.09.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 01/09/2023]
Abstract
AIM While sizeable evidence regarding the association between stressful-life events and multiple sclerosis (MS) disease activity (clinical and/or radiological) was previously documented, their relation to MS risk is controversial. We aimed to investigate the possible association of stressful-life events and multiple sclerosis risk after adjustment for relevant confounders in an Iranian population. METHOD This was a population-based incident case-control study that recruited 547 MS cases and 1057 healthy controls between August 2013 and February 2015, Tehran. The patients were identified using the Iranian MS Society based on 2010 McDonald criteria. We used standard random digit dialing protocol for control selection. Logistic regression model was applied to estimate the odds ratios (95% CI) adjusted for physical activity, age, gender, tobacco smoking, waterpipe smoking and passive smoking. RESULTS While total life events number was not associated with risk of MS, homeless periods OR 3.85 (1.65-8.90), p = 0.002 as well as divorce OR 2.11 (1.24-3.58), p = 0.005 increased the risk of MS. However, marriage OR 0.59 (0.41-0.86), p = 0.006, death of ones' dear OR 0.60 (0.44-0.82), p = 0.002 and joblessness OR 0.61 (0.41-0.91) reduced the risk of MS. CONCLUSION We could not detect a statistically significant role for the total stressful life event during the last 3 years and MS diagnosis. However, there is some evidence confirming the possible role of some individual life events, i.e. divorce and periods of homelessness as potential risk factors for MS and conversely, having married as a protective factor in MS onset.
Collapse
Affiliation(s)
- Ibrahim Abdollahpour
- Department of Epidemiology, School of Public Health, Arak University of Medical Sciences, Arak, Iran.
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Svetlana Eckert
- University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | | |
Collapse
|
35
|
Moghaddam VK, Sarmadi M, Tatari M, Najafi F, Esmaeili A, Hadei M. Epidemiology of Multiple Sclerosis in Torbat-e Heydarieh (Northeast of Iran) during 1982-2016. Mult Scler Relat Disord 2018; 24:184-189. [PMID: 30077941 DOI: 10.1016/j.msard.2018.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 11/30/2022]
Abstract
It was believed that the risk of multiple sclerosis (MS) is associated with latitude gradient. Due to the increasing prevalence of MS in some areas around the equator such as Iran, this theory has been criticized in recent years. Since the distribution of MS in Iran is not uniform, this study was designed to describe the prevalence and incidence of MS in the northeastern area of Iran. The patients were registered in the MS center of Torbat-e Heydarieh County and all of them were living in this county during the study period (during 1 January 1982 to 31 December 2016). Data of the patients were extracted from their files in the MS center. Because of the long-term span of this study, we used different diagnosis criteria according to the files of the patients to proven case missing. In addition, population data were obtained from the website of Statistical Centre of Iran. The total number of the MS patients during the study period was 110 cases. The prevalence of the disease at the beginning and end of the research period was 0.33 (95% CI, 0.008-1.85) and 30.48 (95% CI, 25.25-37.03) patients per 100,000 persons, respectively. The incidence of the disease in this 36-year period was 1.41 (95%CI, 1.15-1.69) patients per 100,000 persons. The average age of the patients was 35.01 (95% CI, 33.37-36.65) years and the female to male ratio was 2.8:1. The prevalence of MS has been increased in the 36-year period in Torbat-e Heydarieh, especially for women. More epidemiological studies are needed to determine the factors affecting this increasing trend.
Collapse
Affiliation(s)
| | - Mohammad Sarmadi
- School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Maryam Tatari
- School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Fereshteh Najafi
- School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Amir Esmaeili
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mostafa Hadei
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
36
|
Mohajer B, Abbasi N, Pishgar F, Abdolalizadeh A, Ebrahimi H, Razaviyoun T, Mohebbi F, Eskandarieh S, Sahraian MA. HLA-DRB1 polymorphism and susceptibility to multiple sclerosis in the Middle East North Africa region: A systematic review and meta-analysis. J Neuroimmunol 2018; 321:117-124. [PMID: 29957381 DOI: 10.1016/j.jneuroim.2018.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 12/17/2022]
Abstract
This meta-analysis explores association of HLA-DRB1 alleles with MS risk in the Middle-east North Africa (MENA) countries. Divided into two groups of alleles (10 studies, 899 cases/1457 controls) and phenotypes (8 studies, 1,040 cases/1,256 controls), Odds ratios (ORs) of DRB1 distribution in MS subjects were assessed using Cochrane RevMan software. DRB1*15 demonstrated significant association with MS in both groups (OR=1.6 and OR=2.51, respectively). In phenotypes, DRB1*03 and DRB1*04 had predisposing role (OR=1.8 and OR=1.9), while DRB1*07 and DRB1*11 were protective (OR=0.56 and OR=0.67). Similar but non-significant trends were seen among alleles, which in sum coincides with a Caucasian-like pattern.
Collapse
Affiliation(s)
- Bahram Mohajer
- MS Research Centre, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Abbasi
- MS Research Centre, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Pishgar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhussein Abdolalizadeh
- MS Research Centre, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hedyeh Ebrahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Taraneh Razaviyoun
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebbi
- MS Research Centre, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- MS Research Centre, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Centre, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
37
|
Abdollahpour I, Nedjat S, Mansournia MA, Sahraian MA, Kaufman JS. Estimating the Marginal Causal Effect of Fish Consumption during Adolescence on Multiple Sclerosis: A Population-Based Incident Case-Control Study. Neuroepidemiology 2018; 50:111-118. [PMID: 29734162 DOI: 10.1159/000487640] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/12/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Adolescence is considered as a critical time period in multiple sclerosis (MS) etiology. Nonetheless, there are insufficient reports regarding the potential role of fresh and canned fish consumptions during adolescence in MS etiology. The authors investigated the association between fresh and canned fish consumptions and MS. METHODS This was a population-based incident case-control study conducted in Tehran. Cases (n = 547) identified from Iranian Multiple Sclerosis Society between August 7, 2013, and November 17, 2015 were included in the study. Population-based controls (n = 1,057) were recruited by random digit telephone dialing without any matching. Inverse-probability-of-treatment weighing (IPTW) using 2 sets of propensity scores and model-based standardization were used to separately estimate the marginal odds ratio between fresh and canned fish consumptions in adolescence and MS. RESULTS The marginal OR for fresh fish was 0.72 (95% CI 0.58-0.90; p = 0.005) in both IPTW analyses. Similarly, the marginal OR for canned fish consumption was 0.75 (95% CI 0.60-0.95; p = 0.014).The model-based standardized OR was 0.72 (95% CI 0.58-0.91; p = 0.008) for fresh and 0.73 (95% CI 0.59-0.94; p = 0.006) for canned fish consumption in adolescence. DISCUSSION Subject to limitation of case-control studies in interpreting associations causally, this study suggests that both fresh and canned fish consumptions in adolescence can decrease the risk of MS.
Collapse
Affiliation(s)
- Ibrahim Abdollahpour
- Department of Epidemiology, School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Knowledge Utilization Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
| |
Collapse
|
38
|
Abdollahpour I, Nedjat S, Mansournia MA, Schuster T. Estimation of the marginal effect of regular drug use on multiple sclerosis in the Iranian population. PLoS One 2018; 13:e0196244. [PMID: 29689063 PMCID: PMC5916854 DOI: 10.1371/journal.pone.0196244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/09/2018] [Indexed: 01/03/2023] Open
Abstract
There are only few reports regarding the role of lifetime drug or substance use in multiple sclerosis (MS) etiology. In this study, we investigated the potential effect of drug or substance exposure on the onset of MS diagnosis. We conducted a population-based incident case control study in Tehran. Cases (n = 547) were 15-50 years old persons with MS identified from the Iranian Multiple Sclerosis Society (IMSS) register during August 7, 2013, and November 17, 2015. Population-based controls (n = 1057) were 15-50 years old and were recruited by random digit telephone dialing. Inverse-probability-of-treatment weighing (IPTW) using two sets of propensity scores (PSs) was used to estimate marginal incidence odds ratios (ORs) for MS contrasting pre-specified substance use. The estimated marginal OR was 6.03 (95% confidence interval: 3.54;10.3, using trimmed weights at the 95th percentile of the stabilized weight distribution) in both IPTW analyses comparing lifetime substance use (opioids, cannabis, inhalants, hallucinogens and stimulants) for at least one time monthly during a six-months or longer period vs. no such history of drug use. Subject to limitation of causal claims based on case-control studies, this study suggests that monthly drug or substance use for a period of at least six consecutive months, may increase the risk of MS by factor 3.5 or higher.
Collapse
Affiliation(s)
- Ibrahim Abdollahpour
- Department of Epidemiology, School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montréal, Quebec, Canada
| |
Collapse
|
39
|
Abdollahpour I, Nedjat S, Mansournia MA, Sahraian MA, van der Mei I. Lifestyle factors and multiple sclerosis: A population-based incident case-control study. Mult Scler Relat Disord 2018; 22:128-133. [PMID: 29677591 DOI: 10.1016/j.msard.2018.03.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/27/2018] [Accepted: 03/28/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Although low sun exposure, low vitamin D, and smoking are established risk factor of multiple sclerosis (MS), there is less evidence on the role of the other lifestyle factors. We examined the association of sun exposure, physical activity, drug abuse, and alcohol intake with MS. MATERIALS AND METHODS This was population-based incident case-control study in Iran with 547 incident cases and 1057 general population controls (7/8/2013-17/2/2015). Logistic regression was used to analyse the data. RESULTS Higher sun exposure during adolescence was associated with a reduced risk of MS, both in summer (test for trend p < 0.001) and winter (P < 0.001), while physical activity was not associated with MS (test for trend p = 0.712). Lifetime drug abuse (OR for ever use 2.93 (1.83-4.70)), with a dose-response association (test for trend p < 0.001), and alcohol intake (OR for ever use 1.49 (1.05-2.12)) was significantly associated with an increased risk of MS. CONCLUSION In a middle-eastern setting, we found that sun exposure during adolescence, drug abuse, and alcohol use were all associated with MS. Increasing sun exposure and reducing drug abuse and the use of alcohol through educational programs is likely to reduce the rate of MS.
Collapse
Affiliation(s)
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Knowledge Utilization Research Center, Tehran University of Medical Science, Tehran, Iran.
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ingrid van der Mei
- Ingrid van der Mei: Menzies Institute for Medical Research, University of Tasmania, Australia
| |
Collapse
|
40
|
Parental ethnicity associated with risk for multiple sclerosis: A population-based incident case–control study in Iran. Mult Scler Relat Disord 2018; 20:100-103. [DOI: 10.1016/j.msard.2018.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/17/2017] [Accepted: 01/12/2018] [Indexed: 11/19/2022]
|
41
|
Zoghi A, Petramfar P, Nikseresht A, Sakhaee E. Investigation of ischemic and demyelinating lesions by cerebral vasoreactivity based on transcranial Doppler sonography: a comparative study. Neuropsychiatr Dis Treat 2018; 14:2323-2328. [PMID: 30254443 PMCID: PMC6141114 DOI: 10.2147/ndt.s150062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Variations of cerebral blood flow in response to hypoxia and hyperoxia in different disease conditions can provide new insights into disease etiopathogenesis. This study aimed to determine the characteristics of cerebral vasoreactivity for ischemia and demyelination. MATERIALS AND METHODS This case-control study included: 28 patients with lacunar infarctions verified by history, physical examination, and MRI; 28 age- and sex-matched healthy controls; 28 patients with relapsing-remitting multiple sclerosis (MS), based on McDonald criteria; and 28 age- and sex-matched healthy controls for the MS group. Transcranial Doppler sonography was undertaken in all subjects to calculate the mean flow velocity (MFV) of the right middle cerebral artery (MCA) and, after a breath-holding (BH) maneuver, the breath-holding index (BHI) was determined. RESULTS There was no significant difference of BHI and changes of MFV of the MCA in MS patients compared to controls (1.02 ± 0.4 vs 1.02 ± 0.3, p = 0.993; and 16.8 ± 8.1 vs 11.3 ± 10.8, p = 0.057). BHI in patients with lacunar infarctions was significantly lower (0.8 ± 0.4 vs 1.2 ± 0.3, p < 0.001) compared to controls. The BHI (p = 0.040) and variations of MFV of MCA (p = 0.007) in MS patients were significantly higher than in patients with lacunar infarctions. The vasoreactivity of demyelinating lesions was higher than that of ischemic ones. CONCLUSION Therefore, cerebral vasoreactivity determined by transcranial Doppler could be utilized for differentiating demyelinating from ischemic lesions.
Collapse
Affiliation(s)
- Anahita Zoghi
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peyman Petramfar
- Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran,
| | - Alireza Nikseresht
- Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran,
| | - Ehsan Sakhaee
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
42
|
Mousavizadeh A, Dastoorpoor M, Naimi E, Dohrabpour K. Time-trend analysis and developing a forecasting model for the prevalence of multiple sclerosis in Kohgiluyeh and Boyer-Ahmad Province, southwest of Iran. Public Health 2017; 154:14-23. [PMID: 29128732 DOI: 10.1016/j.puhe.2017.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 09/15/2017] [Accepted: 10/05/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study was designed and implemented to assess the current situation and to estimate the time trend of multiple sclerosis (MS), as well as to explain potential factors associated with such a trend. METHODS This longitudinal study was carried out based on analysis of the data from the monitoring and treatment surveillance system for 421 patients with MS in Kohgiluyeh and Boyer-Ahmad Province, Iran, from 1990 to 2015. To this end, curve estimation approach was used to investigate the changes in prevalence and incidence of the disease, and univariate time series model analysis was applied in order to estimate the disease incidence in the next 10 years. RESULTS The mean and standard deviation of age were 29.78 and 8.5 years at the time of diagnosis, and the mean and 95% confidence interval of age were 29.18 (28.86-30.77) and 29.68 (28.06-31.30) at the time of diagnosis for women and men, respectively. The sex ratio (males to females) was estimated as 3.3, and the prevalence of the disease was estimated as 60.14 in 100,000 people. The diagram of the 35-year trend of the disease indicated three distinct patterns with a tendency to increase in recent years. CONCLUSION The prevalence and incidence trend of the disease in the study population is consistent with regional and global changes. Climatic and environmental factors such as extreme weather changes, dust particles, expansion of the application of new industrial materials, and regional wars with potential use of banned weapons are among the issues that may, in part, be able to justify the global and regional changes of the disease. Predictive models indicate a growing trend of the disease, highlighting the need for more regular monitoring of the disease trend in upcoming years.
Collapse
Affiliation(s)
- A Mousavizadeh
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
| | - M Dastoorpoor
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - E Naimi
- Department of Public Health, Faculty of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - K Dohrabpour
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| |
Collapse
|
43
|
Vizehfar F, Jaberi A. The Relationship Between Religious Beliefs and Quality of Life Among Patients With Multiple Sclerosis. JOURNAL OF RELIGION AND HEALTH 2017; 56:1826-1836. [PMID: 28502024 DOI: 10.1007/s10943-017-0411-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Patients with chronic diseases, such as multiple sclerosis (MS), are prone to emotional distresses and reduction in life quality more than others. This study aimed to assess the relationship between religious beliefs and quality of life among patients with MS. In this study, 145 MS patients completed 36-Item Short-Form Health Survey (SF-36) and the Duke University Religion Index (DUREL) questionnaires. The results indicated that unorganized religious activities were significantly associated with marital status and education level. Besides, internal religion was positively correlated to mental health. However, religious variables were not effective prognostic factors in physical and mental quality of life. Overall, further studies have to be conducted to determine the role of religion in quality of life of MS patients with different religious backgrounds.
Collapse
Affiliation(s)
- Fatemeh Vizehfar
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Jaberi
- Department of Nursing, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
44
|
Abbasi M, Nabavi SM, Fereshtehnejad SM, Jou NZ, Ansari I, Shayegannejad V, Mohammadianinejad SE, Farhoudi M, Noorian A, Razazian N, Abedini M, Faraji F. Multiple sclerosis and environmental risk factors: a case-control study in Iran. Neurol Sci 2017; 38:1941-1951. [PMID: 28799006 DOI: 10.1007/s10072-017-3080-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 07/21/2017] [Indexed: 01/25/2023]
Abstract
Studies have shown an increase in the incidence of MS in Iran. The aim of our study was to evaluate the relationship between environmental exposure and MS in Iran. This case-control study was conducted on 660 MS patients and 421 controls. Many environmental factors are compared between the two groups. Our findings demonstrated that prematurity ([OR = 4.99 (95% CI 1.34-18.68), P = 0.017]), history of measles and mumps ([OR = 1.60 (95% CI 1.05-2.45), P = 0.029; OR = 1.85 (95% CI 1.22-2.78), P = 0.003, respectively]), breast feeding [OR = 2.90 (95% CI 1.49-5.65), P = 0.002], head trauma in childhood ([OR = 8.21 (95% CI 1.56-43.06), P = 0.013]), vaccination in adulthood ([OR = 4.57 (95% CI 1.14-18.41), P = 0.032, respectively]), migraine ([OR = 3.50 (95% CI 1.61-7.59), P = 0.002]), family history of MS, IBD, migraine, and collagen vascular diseases ([OR = 2.73 (95% CI 1.56-4.78), P < 0.001], [OR = 3.14 (95% CI 1.460-6.78), P = 0.004; OR = 3.18 (95% CI 1.83-5.53), P < 0.001; OR = 1.81 (95% CI 1.03-3.20), P = 0.040, respectively]), stressful events ([OR = 32.57 (95% CI 17.21-61.64), P < 0.001]), and microwave exposure ([OR = 3.55 (95% CI 2.24-5.63), P ≤0.001]) were more in the MS group. Sun exposure ([OR = 0.09 (95% CI 0.02-0.38), P = 0.001]), dairy and calcium consumption ([OR = 0.44 (95% CI 0.27-0.71), P = 0.001]), diabetes mellitus ([OR = 0.11 (95% CI 0.01-00.99), P = 0.049], and complete vaccination during childhood appeared to decreased MS risk. Our results investigated many risk factors and protective factors in Iran.
Collapse
Affiliation(s)
- Maryam Abbasi
- Immunoregulation Research Center, Shahed University, Tehran, Iran.,Medical Students Research Committee, Shahed University, Tehran, Iran
| | - Seyed Massood Nabavi
- Neurology group, Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. .,MS research unit, Mostafa Khomeini Hospital, School of Medicine, Shahed University, Tehran, Iran.
| | - Seyed Mohammad Fereshtehnejad
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Nikan Zerafat Jou
- Medical Students Research Committee, Shahed University, Tehran, Iran
| | - Iman Ansari
- Medical Students Research Committee, Shahed University, Tehran, Iran
| | | | | | - Mahdi Farhoudi
- Neurology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbas Noorian
- Neurology Department, Azad Medical University of Mashhad, Mashhad, Iran
| | - Nazanin Razazian
- Neurology Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahmoud Abedini
- Neurology Department, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fardin Faraji
- Neurology Department, Arak University of Medical Sciences, Arak, Iran
| |
Collapse
|
45
|
Jazaeri A, Vallian S. Association of rs1738074 polymorphism of TAGAP gene with susceptibility to multiple sclerosis in the Iranian population. Neurosci Lett 2017; 648:66-69. [PMID: 28356229 DOI: 10.1016/j.neulet.2017.03.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 03/20/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (CNS) in the Iranian population. To date, association of many genes with the prevalence and progression of the disease have been investigated. In the present study, the impact of rs1738074 single nucleotide polymorphism (SNP) in the TAGAP gene (TAGAP rs1738074) on the risk of MS was evaluated in a sample of the Iranian population. In a case control study, genotyping was performed on 300 patients and normal individuals. The data were analyzed using Pearson's chi-square test. The results showed a significant difference in the SNP frequency between case and control groups (p-value=0.049). The genotype frequencies of TT, TC and CC in patients were 10.67%, 51.33% and 38%, respectively, and in normal individuals were 20.66%, 42.67% and 36.67%, respectively. The results showed a significant difference in the genotype frequency of T/T between the patient and control groups (p<0.05). Interestingly, individuals with T/T genotype were estimated to be less susceptible to MS ((p-value=0.025), Fisher's exact test), odd ratio was 2.18 (controls versus MS patients) with 95% CI: 1.137-4.187. The results suggested that TAGAP rs1738074 polymorphism could be considered as a risk factor in the prevalence of MS in the Iranian population.
Collapse
Affiliation(s)
- Ali Jazaeri
- Division of Genetics, Department of Biology, Faculty of Science, University of Isfahan, Isfahan, IR, Iran
| | - Sadeq Vallian
- Division of Genetics, Department of Biology, Faculty of Science, University of Isfahan, Isfahan, IR, Iran.
| |
Collapse
|
46
|
Akdemir N, Terzi M, Arslan N, Onar M. Prevalence of Multiple Sclerosis in the Middle Black Sea Region of Turkey and Demographic Characteristics of Patients. Noro Psikiyatr Ars 2017; 54:11-14. [PMID: 28566952 DOI: 10.5152/npa.2016.12451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/31/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS), a demyelinating disease of the central nervous system, is increasing in prevalence worldwide. Other than small-scale studies, there is a scarcity of data on the prevalence of MS in Turkey. The present study aimed to elucidate the prevalence of MS in the Middle Black Sea Region and the demographic characteristics of patients. METHODS Patients living in the Middle Black Sea Region and who were diagnosed with MS were included. The study was designed based hospital of Turkey. RESULTS A total of 1,787 patients were interviewed, and a diagnosis of MS was confirmed in 1,584. The prevalence of MS was found to be 43.2/100,000 in the Middle Black Sea Region; this was calculated based on the total population and number of patients in the provinces and districts in this region. The mean age at the disease onset was 29.39±7.6 years. Among the patients, 1,299 (81.9%) had relapsing-remitting MS, 74 had secondary progressive MS, 77 had relapsing-progressive MS, 47 had primary progressive MS, and 87 had clinically isolated syndrome. CONCLUSION The Middle Black Sea Region was found to have a high risk for the prevalence of MS. This study is the most comprehensive epidemiologic study having the largest geographical distribution on the prevalence of MS in Turkey.
Collapse
Affiliation(s)
- Neslihan Akdemir
- Department of Neurology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Murat Terzi
- Department of Neurology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Nilden Arslan
- Department of Public Health, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Musa Onar
- Department of Neurology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| |
Collapse
|
47
|
Mehrabi Z, Nazari F, Mehrabi T, Shaygannejad V. The Effect of Emotional Intelligence Training on Self-efficacy in Women with Multiple Sclerosis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:421-426. [PMID: 29184578 PMCID: PMC5684787 DOI: 10.4103/ijnmr.ijnmr_145_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: Multiple sclerosis (MS), a chronic disease of the central nervous system (CNS), causing progressive nerve damage, has disabling symptoms, and undermines self-efficacy beliefs. Due to the importance of self-efficacy modified in adaptation and coping with stress, this study was conducted with the aim to investigate the effect of emotional intelligence training on self-efficacy in women with MS. Materials and Methods: This randomized clinical trial was conducted on 70 women referring to the Multiple Sclerosis Clinic of Kashani Hospital, Isfahan, Iran. The participants were randomly assigned to two groups through minimization method. In the experimental group, emotional intelligence training was performed within 8 weeks, once a week for 90 minutes, in groups of 8–9 individuals. Data were collected using the Multiple Sclerosis Self-efficacy Scale (MSSS) before, immediately after, and 3 months after the intervention in both groups. Data were analyzed using independent t-test and repeated measures ANOVA in SPSS. Results: The results of independent t-test showed no significant difference between the groups in terms of mean self-efficacy scores before the intervention (p > 0.05). However, there was a significant difference between the groups in this regard immediately after and 3 months after the intervention (p < 0.05). Repeated measures ANOVA showed a significant difference in the mean score of self-efficacy and its components between the groups at different times (p < 0.05). Conclusions: It seems that emotional intelligence training is effective on the improvement of self-efficacy of women with MS. Hence, this method can be recommended as an effective and affordable technique.
Collapse
Affiliation(s)
- Zahra Mehrabi
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nazari
- Isfahan Neurosciences Research Center, Department of Adult Health Nursing, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tayebe Mehrabi
- Department of Psychological Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Centre, Neurology Department, School of Medicine, University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
48
|
Abdollahpour I, Nedjat S, Sahraian MA, Mansournia MA, Otahal P, van der Mei I. Waterpipe smoking associated with multiple sclerosis: A population-based incident case-control study. Mult Scler 2016; 23:1328-1335. [PMID: 27834737 DOI: 10.1177/1352458516677867] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND While cigarette and passive smoking have been identified as modifiable risk factors for multiple sclerosis (MS), there is no report regarding Waterpipe smoking-MS association. OBJECTIVE We examined the association of Waterpipe, tobacco, and passive smoking with MS. METHODS Population-based incident case-control study in Iran with 547 incident cases and 1057 general population controls (7 August 2013-17 February 2015). Logistic regression model was used. Multiplicative along with additive interaction was assessed using product term and Synergy Index (SI), respectively, and the population attributable fractions (PAFs) were calculated. RESULTS Having ever smoked Waterpipe, tobacco, or being exposed to passive smoking were all significantly associated with MS (odds ratio (OR) = 1.77 (1.36-2.31), OR = 1.69 (1.24-2.31), and OR = 1.85 (1.48-2.32), respectively). Clear dose-response associations were observed with the duration exposed ( p < 0.001 for all three) and the amount smoked ( p < 0.001 for Waterpipe and tobacco). Those who had all three types of smoking had an odds that was 4.1 times higher than those without any type. The three types of smoking jointly contributed to 30.9% of the MS incidence. CONCLUSION We identified Waterpipe smoking as a novel risk factor for MS. Given the global increase in Waterpipe smoking, especially among young adults, this finding reinforces the need for public health interventional and educational programs to combat this global increase.
Collapse
Affiliation(s)
- Ibrahim Abdollahpour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran/School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran/Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| |
Collapse
|
49
|
Sahraian MA, Naghshineh H, Shati M, Jahromi SR, Rezaei N. Persian adaptation of a questionnaire of environmental risk factors in multiple sclerosis (EnvIMS-Q). Mult Scler Relat Disord 2016; 10:82-85. [DOI: 10.1016/j.msard.2016.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/05/2016] [Accepted: 09/13/2016] [Indexed: 01/28/2023]
|
50
|
Alizadeh A, Mehrpour O, Nikkhah K, Bayat G, Espandani M, Golzari A, Jarahi L, Foroughipour M. Comparison of serum Concentration of Se, Pb, Mg, Cu, Zn, between MS patients and healthy controls. Electron Physician 2016; 8:2759-2764. [PMID: 27757186 PMCID: PMC5053457 DOI: 10.19082/2759] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/25/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Multiple Sclerosis (MS) is defined as one of the inflammatory autoimmune disorders and is common. Its exact etiology is unclear. There are some evidences on the role of environmental factors in susceptible genetics. The aim of this study is to evaluate the possible role of Selenium, Zinc, Copper, Lead and Magnesium metals in Multiple Sclerosis patients. METHODS In the present analytical cross-sectional study, 56 individuals including 26 patients and 30 healthy controls were enrolled in the evaluation. The serum level of Se, Zn, Cu, Pb were quantified in graphite furnace conditions and flame conditions by utilizing an atomic absorption Perkin Elmer spectrophotometer 3030. The serum levels of Mg were measured by auto analyzer 1500 BT. The mean level of minerals (Zn, Pb, Cu, Mg, Se) in serum samples were compared in both cases and controls. The mean level of minerals (Zn, Pb, Cu, Mg, Se) in serum samples were compared in both cases and controls by using independent-samples t-test for normal distribution and Mann-Whitney U test as a non-parametric test. All statistical analyses were carried out using SPSS 11.0. RESULTS As well as the Zn, Cu, and Se, there was no significant difference between MS patients and healthy individuals in Pb concentrations (p-value = 0.11, 0.14, 0.32, 0.20 respectively) but the level of Mg was significantly different (p= 0.001). CONCLUSION All serum concentrations of Zn, Pb, Se, Cu in both groups were in normal ranges and there was no difference in MS patients compared with the healthy group who were matched in genetics. Blood level of Mg was significantly lower in MS patients. But it should be noted that even with the low level of serum magnesium in MS patients, this value is still in the normal range.
Collapse
Affiliation(s)
- Anahita Alizadeh
- MD, Pediatrician, Fellowship of Toxicology, Assistant Professor, Department of Clinical Toxicology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Mehrpour
- Fellowship of Clinical Toxicology, Associate Professor, Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Moallem Avenue, Birjand, Iran
| | - Karim Nikkhah
- Associate Professor of Neurology, Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Golnaz Bayat
- Medical Student, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Espandani
- Neurologist, Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Golzari
- Medical Student, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Lida Jarahi
- MD, MPH, Associate Professor in Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Foroughipour
- Professor of Neurology, Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|