Epidemiological characteristics of multiple sclerosis in Volyn region: a prospective study
Abstract
Background: Multiple sclerosis (MS) is the most common non-traumatic cause of central nervous system disorders in young people worldwide, leading to cognitive and physical disability. About 20,000 of adult Ukrainians suffer from MS. Prospective studies, taking into account the prevalence and incidence, combined with environmental, territorial and urbanization factors can optimize medical care for patients with MS. A prospective study of MS within Volyn Polissia and Opillya zones has not been conducted before.
Objective: To evaluate prospectively the prevalence and morbidity rates of MS among the adult population of Volyn region within the physical-geographical zones.
Materials and methods: Epidemiological and medical-statistical methods of morbidity study were used to study features of MS prevalence in the Volyn region. The standard descriptive statistics and factor analysis (principal component method) were used to estimate the variation of a set of indicators. Factor analysis included incidence and prevalence rates of MS in Volyn region since 1999.
Results: A statistically significant difference in MS prevalence at the significance level p <0.05 was found in the MS prevalence in 2014 and at the p = 0.005 level in the 2015–2017 section. Also, a statistically significant difference in the incidence of MS at a significance level of p <0.1 was detected in the incidence of MS in 2015 and at the level of p = 0.001 in 2013. Thus, comparing the prevalence and incidence rates, we can conclude that the prevalence of MS in the Volyn Opillya region is significantly higher than in the Volyn Polissia area. Factor analysis (principal component method) was conducted to identify latent factors. As a result, it was found that the 3-factor model allows to describe more than 88% of the variation of the set of indicators: the 1st (main) factor describes 69%, the 2nd - 12,6%, the 3rd - 6,6% (together 88,2%).
Conclusions: The prevalence and incidence rates of MS in the Volyn Oblast were found to be uneven. The prevalence of MS in the Volyn Polissia area is lower than in the Volyn Opillia region. The developed 3-factor model allows to describe more than 88% of the variation of the population prevalence of MS. In our opinion, it is advisable to consider the incidence and prevalence rates of MS comprehensively, taking into account environmental, territorial, urban and, not excluded, industrial indicators.
Downloads
References
Kobelt, G., Thompson, A., Berg, J., Gannedahl, M., & Eriksson, J. New insights into the burden and costs of multiple sclerosis in Europe. Multiple Sclerosis Journal. 2017, vol. 23, no. 8, pp. 1123–1136. DOI: 10.1177/1352458517694432
Hemmer B, Kerschensteiner M, Korn T. Role of the innate and adaptive immune responses in the course of multiple sclerosis. The Lancet. Neurology. 2015, vol. 14, no. 4, pp. 406-419. DOI: 10.1016/s1474-4422(14)70305-9.
Federation MSI. Atlas of MS 2013: Mapping Multiple Sclerosis around the world; 2013. Available at: http://www.atlasofms.org. Accessed April 10, 2017.
Browne, P., Chandraratna, D., Angood, C., Tremlett, H., Baker, C., Taylor, B. V., & Thompson, A. J. Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity. Neurology. 2014, vol. 83, no. 11, pp. 1022–1024. DOI:10.1212/WNL.0000000000000768
Mishhenko, T. S., Shulga O.D., Bobryk N.V., Shulga L.A. Multiple sclerosis: global perspectives. Ukr. medical magazine. 2014, no. 3, pp. 84–87. [in Ukr.]
Shulga, O. D. Clinical and epidemiological characteristics of multiple sclerosis in the Volyn region. Problems of continuing medical education and science. 2015, no. 1, pp. 16–18. [in Ukr.]
Euroregion "Bug: Problems and prospects of cross-border cooperation. Luzk: Volyn. rig. state administration,1996. – 152 s. [in Ukr.]
Poruchynsky V.I. Natural and geographical factors of settlement of the population of Volyn region. Scientific notes of Ternopil National Pedagogical University named after Volodymyr Hnatyuk. Series: Geography. 2015, no. 1, pp. 92-96. [in Ukr.]
Bobryk N. V. Clinical and epidemiological characteristics of multiple sclerosis in the Volyn region. Doct. Diss. Nat. med. acad. postgraduate. education named after PL Shupik. Kyiv. 2017, 20 p. [in Ukr.]
The use of statistical analysis methods for the study of public health and healthcare. V.Z. Kucherenko. M .: GEOTAR-Media, 2004.192 p. [in Russ.]