American Journal of Epidemiology and Infectious Disease:

Home » Journal » ajeid » Archive » Volume 1, Issue 1

Article

Epidemiologic Data of Multiple Sclerosis in Northern Greece during the Last Thirty Years (1979-2008)

1Department of Neurology, AHEPA Hospital, School of Medicine, Aristotle University, Thessaloniki, Greece


American Journal of Epidemiology and Infectious Disease. 2013, 1(1), 1-7
DOI: 10.12691/ajeid-1-1-1
Copyright © 2013 Science and Education Publishing

Cite this paper:
Euphrosyni Koutsouraki, Aikaterini Fotakidou, Thalia Kalatha, Stavros Baloyannis. Epidemiologic Data of Multiple Sclerosis in Northern Greece during the Last Thirty Years (1979-2008). American Journal of Epidemiology and Infectious Disease. 2013; 1(1):1-7. doi: 10.12691/ajeid-1-1-1.

Correspondence to: Euphrosyni Koutsouraki, Department of Neurology, AHEPA Hospital, School of Medicine, Aristotle University, Thessaloniki, Greece. Email: efrosink@gmail.com

Abstract

The epidemiologic profile of multiple sclerosis (MS), one of the most common diseases of the central nervous system, is not well defined in northern Greece. We analyzed retrospectively the records of the MS patients admitted in our Neurology Department, between the years 1979-2008. We studied a total of 1180 MS patients, with an average annual rate of 39 ± 11.8 MS patients, demonstrating a female to male ratio of 1.6:1. The estimated prevalence of MS in Thessaloniki, the largest city in northern Greece, on December 31 2008, was 57:100,000 placing the area in the high-risk zone while it was 6,8:100,000 on December 31, 1981, in the medium-risk zone. The mean age during the exacerbation of the disease was 28 ± 9 years for females and 31 ± 8 years for males, with significant difference between means (t = 5,8, p < 0,001). The average annual rate of attacks was 1.6 ± 0.7 per 100.000 population. Patients’ admissions was significantly less in winter with comparison to the other seasons (t = 3, p = 0,002). As far as monthly distribution, the maximum number of admissions was noted in May (121 patients, 10.25%) and September (118 patients, 10%) and the minimum in December (58 patients, 4.9%). Our study indicates an increase of the incidence of MS in northern Greece, central Macedonia prefecture and mainly in the city of Thessaloniki, during the last 30 years.

Keywords

References

[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[
[[1]  Achenson E. Epidemiology of MS. Br Med Bull 1977; 33:9-14.
 
[[2]  Alter M, Halpern L, Kurland L, et al. MS in Israel prevalence among imigrants and native inhabitants. Arch Neurol 1966; 7:253-263.
 
[[3]  Allison RS, Millar JH. Prevalence of disseminated sclerosis in Northern Ireland. Ulster Med J 1954; 23 (Suppl. 2): 1-27.
 
[[4]  Schumacher GA, Beebe G, Kibler RF, et al. Problems of experimental trials of therapy in multiple sclerosis. Ann N Y Acad Sci 1965; 122: 552-68.
 
[[5]  Poser C, Paty D, Scheinberg L, et al. New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Ann Neurol 1983; 13:227-231.
 
Show More References
[6]  McDonald I, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50(1): 121-127.
 
[7]  Polman CH, Reingold SC, Edan, G, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the McDonald Criteria. Annals of neurology 2005, 58 (6): 840-6.
 
[8]  Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Annals of neurology 2011, 69 (2): 292-302.
 
[9]  Miller A, Bourdette D, Cohen JA, et al. Multiple sclerosis. Continuum 1999; 5: 3-185.
 
[10]  Klupka-Saric I, Ristic S, Sepcic J, Kapovic M, Peterlin B, Materljan, E et al. Epidemiology of multiple sclerosis in western Herzegovina. Clinical Neurology and Neurosurgery 2007;109, 779-783.
 
[11]  Pekmezovic T, Jarebinski M, Drulovic J, Stojsavljevic N, Levic Z. Prevalence of multiple sclerosis in Belgrade, Yugoslavia. Acta Neurologica Scandinavica, 2001; 104, 353-357.
 
[12]  Milanov I, Georgiev D, Kmetska K, Jordanova L, Topalov N. Prevalence of multiple sclerosis in Bulgaria. Neuroepidemiology 1997; 16: 304-307.
 
[13]  Milanov I, Topalov N, Kmetska TS. Prevalence of multiple sclerosis in Gipsies and Bulgarians. Neuroepidemiology 1999; 18: 218-222.
 
[14]  Guseo A, Jofeiu E, Kocsis A. Epidemiology of multiple sclerosis in Western Hungary 1957-1992. In: Firnhaber W, Lauer K, eds. “Multiple Sclerosis in Europe: An Epidemiological Update”. Darmstadt: Leuchtturm-Verlag/LTV Press, 1994; 279-286.
 
[15]  Rose AS, Ellison GW, Myers LW, Tourtellotte WW. Criteria for the clinical diagnosis of multiple sclerosis. Neurology 1976; 26: 20-22.
 
[16]  Kruja J. Multiple sclerosis in Albania. In: Firnhaber W, Lauer K, eds. “Multiple Sclerosis in Europe: An Epidemiological Update”. Darmstadt: Leuchtturm-Verlag/LTV Press, 1994; 309-315.
 
[17]  Papathanasopoulos P, Gourzoulidou E, Messinis L, Georgiou V, Leotsinidis M. Prevalence and incidence of multiple sclerosis in western Greece: a 23 year survey. Neuroepidemiology 2008; 30(3):167-173.
 
[18]  Koutsouraki E, Costa V, Baloyannis S. Epidemiology of multiple sclerosis in Europe: a review. Intern Rev Psych 2010; 22(1): 2-13.
 
[19]  Piperidou HN, Heliopoulos IN, Maltezos ES, Milonas IA. Epidemiological data of multiple sclerosis in the province of Evros, Greece. Eur Neurol 2003; 49(1):8-12.
 
[20]  Military Geographical Service, www.gys.gr, (Accessed June, 2nd, 2012).
 
[21]  National Statistical Agency Greece, dlib.statistics.gr (Accessed June, 2nd, 2012).
 
[22]  Kurland L, Westlund K. Studies on MS in Winnipeg, Manitoba and New Orleans, Louisiana. II. A controlled investigation on factors in the life history of the Winnipeg patients. Am J Hyg 1953; 57: 380-407.
 
[23]  Lauer K. Mortality of MS in relation to geographic factors in France. Neuroepidemiology 1990; 9(3):113-117.
 
[24]  Bamford C, Sibley W, Thies C. Seasonal variation of MS exacerbation in Arizona. Neurology 1983; 33: 697-701.
 
[25]  Koutsouraki E, Koukoulidis I, Parlapanis A, et al. Epidemiological study of multiple sclerosis in patients of A’ Neurological Clinic of Aristotelian University, Thessaloniki, during the years 1973-1992. Encephalos 1994; 31:103-111.
 
[26]  Concise Statistical yearbook 2008, National Statistical Service of Greece, Ministry of Economy and Finance, Hellenic Republic, Pireas 2009.
 
[27]  Pugliatti M, Rosati G, Carton H, Riise T, Drulovic J, Vécsei L, Milanov I. The epidemiology of multiple sclerosis in Europe, European Journal of Neurology 2006, 13 (7), 700-722.
 
[28]  Fangerau T, Schimrigk S, Haupts M et al. Diagnosis of multiple sclerosis: comparison of the Poser criteria and the new McDonald criteria. Acta Neurologica Scandinavica 2003; 109: 385-389.
 
[29]  McDonnell GV, Hawkins SA. Clinical study of primary progressive multiple sclerosis in Northern Ireland, UK. Journal of Neurology, Neurosurgery and Psychiatry 1998; 64: 451-454.
 
[30]  Baloyannis S, Michael J, Arnaoutoglou A, Ierodiakonou H, Diakogiannis A. Some data of MS in Greece. Annals Medical School of Aristotle University Thessaloniki 1979; 12: 147-155.
 
[31]  Milonas I, Tsounis S, Baloyannis JS, Fekas L, Logothetis I. Epidemiologic study of MS in Prefecture of Thessaloniki. Encephalos 1988; 25:173-176.
 
[32]  Milonas I, Tsounis S, Logothetis I. Epidemiologic study of MS in Northern Greece. Acta Neurol Scand 1990; 81(1):43-47.
 
[33]  Strikis G, Zafiropoulos A, Tsikna E, Siamoulis K, Fekas L, Baloyannis SJ. Epidemiologic data in non-hospitalized MS patients. Neurological Subjects 1991; 2:116-119.
 
[34]  European Multiple Sclerosis Platform, www.emsp.org (Accessed June, 23nd, 2012).
 
[35]  Kurtzke JF. An epidemiologic approach to MS. Arch Neurol 1966; 14:213-222.
 
[36]  Poskanzer D, Sheridan J, Premey J, Walker A. MS in the Orkney and Shetland Islands. II. The search for an exogenous aetiology. Journal of Epidemiology Community Health 1980; 34:240-252.
 
[37]  Lauer K, Firnhaber W. Prognostic criteria in a epidemiological group of patients with MS an exploratory study. J Neurol 1992; 239(2):93-97.
 
[38]  Ebers GC, Sadovnick AD, Risch NJ, for the Canadian Collaborative Study Group. A genetic basis for familial aggregation in multiple sclerosis. Nature 1995; 377: 150-51.
 
[39]  Sadovnick AD, Ebers GC, Dyment DA, Risch NJ, for the Canadian Collaborative Study Group. Evidence for genetic basis of multiple sclerosis. Lancet 1996; 347: 1728-30.
 
[40]  Sadovnick AD, Armstrong H, Rice GPA, et al. A population-based study of multiple sclerosis in twins: update. Ann Neurol 1993; 33: 281-85.
 
[41]  Mackay RP, Myrianthopoulos NC. MS in twins and their relatives. Final report. Arch Neurol 1966; 15:449-462.
 
[42]  Sadovnick A, Baird P. Reproductive counseling for MS patients. Am J Med Genet 1985; 20(2):349-354.
 
[43]  Birk K, Rudick R. MS and pregnancy. Arch Neurol 1986; 43(7):719-726.
 
[44]  Swank R, Lerstad O, Strom A, Backer J. MS in rural Norway. Its geographic and occupational incidence in relation to nutrition. New Engl J Med 1952; 246:71-78.
 
[45]  Alter A, Loewenson R, Harshe M. The geographic distribution of MS: an examination of mathematical models. J Chron Dis 1973; 26:755-767.
 
[46]  Kurtzke JF. Geographic distribution of MS: an update with a special reference to Europe and the Mediterranean region. Acta Neurol Scand 1980; 62:65-80.
 
[47]  Sibley W, Paty D. A comparison of MS in Arizona and Ontarion preliminary report. Acta Neurol Scad 1981; 64(87):60-65.
 
[48]  Kurtzke JF. Epidemiology of multiple sclerosis. Does this really point toward etiology? Lectio Doctoralis. Neurol Sci 2000; 21:383-403.
 
Show Less References
comments powered by Disqus