Prevalence of multiple sclerosis in the province of Teruel, Spain

Pardo, P. J. Modrego; Latorre, Mercedes Alfaro; López, A.; Errea, José M.; Modrego, Pedro J.

doi:10.1007/s004150050070

Cited by 46 publications

(18 citation statements)

References 18 publications

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“…) Generally, lower MS prevalence rates have been reported in the lower latitudes. The rates reported for Spain fit this pattern, with estimates ranging between 0.04 and 0.08 [2,3,4,5], versus rates of approximately 0.15 in Ireland, Norway and Sweden [6,7]. Age at onset is typically 20 to 40 years, and women are more affected.…”

Section: Introductionsupporting

confidence: 54%

Costs and quality of life of multiple sclerosis in Spain

Kobelt¹,

Berg²,

Lindgren³

et al. 2006

Eur J Health Econ

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This cost-of-illness analysis is based on information from 1.848 patients in Spain and is part of a Europe-wide study on the costs of multiple sclerosis. The objective was to analyze the costs and quality of life (QOL) related to the level of disease severity and progression. Patients were identified by the Asociación Española de Esclerosis Múltiple (AEDEM) and participated in the survey by answering a mail questionnaire (response rate 31.8%). In addition to details on the disease (type of disease, relapses, level of functional disability), the questionnaire asked for information on all resource consumption, medical, non-medical, work absence and informal care, as well as utility (QOL). The mean age of the cohort was 45 years, and only 5.5% of patients were 65 years of age or more. Approximately 36% of patients had mild disease (Expanded Disability Status Scale [EDSS] score of 0-3), 44.8% had moderate disease (EDSS score of 4-6.5) and 17.7% had severe disease (EDSS score > or =7). The mean EDSS score in the sample was 4.5 (median 5.0), with a utility of 0.554. Costs and utility are highly correlated with disease severity. Workforce participation decreases from around 70% in early disease to less than 5% in the very late stages. Hospitalization is very infrequent in early disease, representing less than euro 1.300 per patient per year for patients at EDSS scores <6, but increases steeply for patients at scores > or =7. Ambulatory care increases fivefold between early and late disease, while investments and services increase from basically no cost to just over euro 6.000 at EDSS scores > or =7. Productivity losses increase more than eightfold, and informal care increases from euro 593 at EDSS scores of 0-1 to nearly euro 34.228 at scores of 8-9. Hence, total mean costs per patient are driven by the distribution of the severity levels in the sample, increasing from euro 10.425 at EDSS scores of 0-1 to euro 45.264 at a score of 7, and euro 65.693 at scores of 8-9. The same is true for utility, which decreases from 0.865 to 0.084 as patients progress from the mildest to the most severe disability levels. However, the utility loss compared to the age- and gender-matched general population is high at all levels of the disease ( approximately 0.25 in patients below 30 years of age with an EDSS score of 2-3, and approximately 0.4 in patients over 60 years of age and a score of > or =6), leading to an estimated annual loss of 0.276 quality-adjusted life-year per patient. Relapses for patients with an EDSS score below 5 are associated with a cost of approximately euro 2.750 and a utility loss of 0.1 during the quarter in which they occur.

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Section: Introductionsupporting

confidence: 54%

Costs and quality of life of multiple sclerosis in Spain

Kobelt¹,

Berg²,

Lindgren³

et al. 2006

Eur J Health Econ

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“…Likewise, the annual incidence rate of the current study over a 20‐year period was 4.6 per 100,000, a figure much higher than that reported in previous epidemiologic studies in Spain (incidence rates of between 2.2 and 3.8 per 100,000 per year) 19, 22, 23, 25. As the genetic background of the population of Northern Seville District of Spain is not very different from other areas of Spain and the rest of South Europe, this was unexpected.…”

Section: Discussioncontrasting

confidence: 63%

“…report a much higher prevalence of MS than in previous epidemiologic studies conducted in the 1990s in various regions of Spain (32–65 per 100,000 population), including an earlier study in southern Spain by Fernandez et al. 19, 20, 21, 22, 23, 24, 25. The higher prevalence compared with earlier studies is probably related to numerous factors, including higher survival in MS and better diagnostic accuracy 26.…”

Section: Discussionmentioning

confidence: 99%

Long‐term epidemiology of multiple sclerosis in the N orthern S eville D istrict

et al. 2015

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ObjectivesComprehensive epidemiologic data for multiple sclerosis (MS) in Spain are limited. The aim of this study was to collect epidemiologic data on MS in the Northern Seville District of Spain.Materials and methodsThis longitudinal study identified possible MS cases every year from nine centres between 1 January 1991 and 31 December 2011. Patients with a confirmed diagnosis of MS were included. MS data prior to enrolment were collected retrospectively from clinical records and prospectively during quarterly follow‐up clinic visits. Variables included age at onset, age at diagnosis, treatment, follow‐up duration, number of visits, number of relapses, change in the number of relapses over time and Expanded Disability Status Scale score. The incidence and prevalence of MS rate were calculated.ResultsOverall, 156 patients with MS were identified (111 females; mean follow‐up 7.5 years). Most patients had relapsing‐remitting MS (73.7%); primary progressive disease was less frequent than secondary disease (10.9% vs 15.4%). The yearly incidence of MS was 4.6 per 100,000, and the prevalence at 31 December 2011 was 90.2 per 100,000.ConclusionsThe annual MS incidence rate in this southern region of Spain was higher than previously reported rates in Spanish studies.

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“…Zivadinov/Iona/Monti-Bragadin/Bosco/ Jurjevic/Taus/Cazzato/Zorzon [10] 37° S 1981 71 Australia, Newcastle [9] 32° S 1981 73 Australia, Perth [9] 31° S 1981 73 Australia, New South Wales [11] 30-33° S 1981 69 Australia, South Australia [11] 27-30° S 1981 69 Brazil, City of Sao Paolo [12] 23-24° S 1981 69 Australia, Queensland [13] 10-19° S 1981 73 India, Bombay [14] 19° N 1988 70 Japan, 10 cities [15] 26-44° N 1972-1978 76 Kuwait (in Kuwaitis) [16] 28-30° N 1988 69 Kuwait (in Palestinians) [16] 28-30° N 1988 69 Libya, Benghazi [17] 32° N 1984 75 Israel, native-born Israelis whose father was born in Europe or in America [18] 34° N 1981 74 Israel, native-born Israelis whose father was born in Africa or Asia [18] 34° N 1981 74 Israel, native-born Israelis whose father was born in Israel [18] 34° N 1981 74 Israel, immigrants to Israel born in Africa or Asia [18] 34° N 1981 74 Spain, Velez-Malaga [19] 36° N 1991 69 Italy, Sicily, Monreale [20] 38° N 1991 69 Spain, Alcoy, Valencia [21] 39° N 1988 73 Greece, Northern Greece [22] 39-41° N 1984 75 Spain, Teruel [23] 39-41° N 1996 69 Italy, Sardinia, Alghero [24] 40° N 1980 70 Italy, Sardinia, Sassari [25] 41° N 1985 70 Italy, Northwestern Sardinia [26] 41° N 1991 69 Spain, Catalonia, Osona [27] 41° N 1991 69 Spain, Asturias, Gijon health district [28] 43° N 1994 69 Canada, Ontario, London County [29] 43° N 1984 70 Italy, Ferrara [30] 44° N 1993 69 Italy, Reggio Emila and Modena [31] 44° N 1990 72 Italy, Modena [32] 44° N 1990 72 USA, Minnesota, Olmsted County [33] 44° N 1 9 7 8 7 0 USA, Minnesota, Rochester [33] 44° N 1 9 7 8 7 0 USA, Minnesota, Mower County [33] 44° N 1 9 7 8 7 0 USA, Minnesota, Olmsted County …”

Section: Resultsmentioning

confidence: 99%

The Use of Standardized Incidence and Prevalence Rates in Epidemiological Studies on Multiple Sclerosis

Zivadinov

Iona²,

Monti-Bragadin

et al. 2003

Neuroepidemiology

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Objective: To demonstrate whether or not the age and sex adjustment of incidence and prevalence rates in multiple sclerosis (MS) could allow more reliable comparison between epidemiological studies performed in different areas of the world and to establish if the latitude gradient theory could be confirmed after the standardization for age and sex distribution. Methods: A meta-analysis of population-based incidence and prevalence studies on MS from 1980 through 1998 using the terms ‘multiple sclerosis’, ‘prevalence’ and ‘incidence’ in the bibliographic databases MEDLINE and EMBASE was performed. We included studies that reported the diagnostic criteria, number of cases and the population studied, the date of the study, the latitude, and the age- and sex-specific crude incidence and prevalence rates. According to the inclusion criteria, 69 of 127 papers on prevalence and 22 of 70 papers on incidence were considered for age adjustment and 27 prevalence and 8 incidence studies for sex adjustment. The mean incidence and prevalencerates and the 95% confidence intervals age- and sex-adjusted to the World and the European standard populations were calculated. Results: The Spearman rank correlation and the multiple regression analyses indicated that age adjustment to standard populations could overcome the limitations in comparing the crude prevalence and incidence rates of different epidemiological studies on MS. When the mean crude and age- and sex-adjusted prevalence and age-adjusted incidence rates were stratified by latitude (from south to north), the latitudinal gradient, which was highly significant for the crude rates, became less remarkable for the age- and sex-adjusted prevalence rates and not significant for the age-adjusted incidence rates. Conclusions: The crude incidence and prevalence rates in epidemiological studies on MS should be age- and sex-adjusted to a common standard population to permit a more reliable comparison among studies performed in different countries. Our findings support the opinion that the latitude does not play a key role in determining the onset of MS. Whenever possible, the crude incidence and prevalence rates should be adjusted to the ethnic origin and migration characteristics.

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Prevalence of multiple sclerosis in the province of Teruel, Spain

Cited by 46 publications

References 18 publications

Costs and quality of life of multiple sclerosis in Spain

Costs and quality of life of multiple sclerosis in Spain

Long‐term epidemiology of multiple sclerosis in the N orthern S eville D istrict

The Use of Standardized Incidence and Prevalence Rates in Epidemiological Studies on Multiple Sclerosis

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