High Prevalence and Fast Rising Incidence of Multiple Sclerosis in Caltanissetta, Sicily, Southern Italy

Abstract

Background: Epidemiological studies conducted in Sicily and Sardinia, the two major Mediterranean islands, showed elevated incidence and prevalence of multiple sclerosis (MS)and a recent increase in disease frequency. Objective: To confirm the central highlands of Sicily as areas of increasing MS prevalence and elevated incidence, we performed a follow-up study based on the town of Caltanissetta (Sicily), southern Italy. Methods: We made a formal diagnostic reappraisal of all living patients found in the previous study performed in 1981. All possible information sources were used to search for patients affected by MS diagnosed according to the Poser criteria. We calculated prevalence ratios, for patients affected by MS who were living and resident in the study area on December 31, 2002. Crude and age- and sex-specific incidence ratios were computed for the period from January 1, 1993, to December 31, 2002. Results: The prevalence of definite MS rose in 20 years from 69.2 (retrospective prevalence rate) to 165.8/100,000 population. We calculated the incidence of definite MS for the period 1970–2000. These rates calculated for 5-year periods increased from 2.3 to 9.2/100,000/year. Conclusion: This survey shows the highest prevalence and incidence figures of MS in the Mediterranean area and confirms central Sicily as a very-high-risk area for MS.

Prevalence of Multiple Sclerosis in Tuscany (Central Italy): A Study Based on Validated Administrative Data

“…Rather, it could reflect a possible actual increase of incidence, as previously hypothesized [6,13,14,15,16] but not yet demonstrated.…”

“…In Tuscany, the latest estimates show a prevalence of 56 per 100,000 (1991) [11] and a mortality of 0.4 for males and 0.6 for females (2002-2006) [12]. Nowadays, in Italy, prevalence is absolutely higher than the above-mentioned estimates because incidence exceeds mortality [13] and this difference will probably increase, according to the notion that MS incidence is increasing over time [6,13,14,15,16]. Some authors even hypothesize an increase in the incidence due not only to the improvement of diagnostic technique and earlier diagnosis but probably also to some still unknown environmental etiological factors [15].…”

Prevalence and Incidence of Multiple Sclerosis in Western Greece: A 23-Year Survey

“…There is general consensus from epidemiological data obtained from several European countries that the prevalence of MS decreases with geographical latitude [1,5,6] . The prevalence of MS in Europe and in the Mediter-Papathanasopoulos /Gourzoulidou / Messinis /Georgiou /Leotsinidis Neuroepidemiology 2008;30:167-173 168 ranean region is related to the geographic latitude and is composed of two separate zones, one for high and one for medium prevalence rates.…”

Persisten las preguntas: Factores ambientales en las enfermedades autoinmunes

“…"Pero también hay estudios muy buenos que muestran incrementos reales, en particular de la diabetes tipo 1." 6,7 El hecho de que la diabetes tipo 1 ha estado bien caracterizada durante décadas constituye hasta el momento una evidencia convincente de que el incremento en la incidencia no es una mera ilusión basada en un mejor diagnóstico.…”