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 sexspecific 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.

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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.

Background: Information of Previous studies on the prevalence of MS, including our study conducted twelve 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 twelve 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 3332556, (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.

Background: Multiple Sclerosis (MS) patients experience a variety of disease caused disabilities that makes them more vulnerable to the effects of disasters. This study aimed to review all existed studies about disasters and related disaster management planning about MS patients. Methods: The PubMed, Google Scholar, Scopus, and Web of Science, ProQuest, science direct , and grey literature databases were searched up to the mid of 2021. All obtained titles were assessed by the inclusion criteria. Abstracts of the relevant titles were reviewed and eligible articles/documents were included for full text review and data abstraction. Results: From 24616 Articles/documents, finally 15 documents (13 articles, and 2 books) were selected. In 8 articles (53%) specifically, focused on MS patients and, in the rest focused on them as a member of people with disabilities. Most studies (10, 71.4%), emphasized on the disaster induced stress effect on MS patients. In two books/book sections, the disaster preparedness plan for all types of disabilities was presented in general, and MS patients were mentioned as a member of the group of patients with disabilities. Conclusion: Despite the importance of planning in response to disasters to address specific problems of MS patients, there is a lack of proper planning. This is very important and there is an urgent need to develop appropriate planning protocols for addressing the special conditions of MS patients in response to disasters.