Cabre P, Gonzalez-Quevedo A, Lannuzel A, Bonnan M, Merle H, Olindo S, Chausson N, Lara-Rodriguez R, Smadja D, Cabrera-Gomez J
CHRU Pierre-Zobda-Quitman, Fort-de-France, Martinique.
Rev Neurol (Paris). 2009 Aug-Sep;165(8-9):676-83. doi: 10.1016/j.neurol.2009.02.012. Epub 2009 Apr 29.
Data on epidemiology of neuromyelitis optica (NMO) remained scarce in the last century, but the recent development of diagnostic criteria now enables inclusion of both monophasic and relapsing NMO in epidemiologic studies. Given the rarity of NMO, multicentric studies are needed to confirm a presumed higher frequency in women and in populations of black/Asian ancestry. The Caribbean basin is a suitable area for collecting a large NMO cohort and to assess the prevalence, incidence, and mortality of this disorder.
This population-based survey of the NMO spectrum in the French West Indies (FWI) and Cuba included 151 cases.
Ninety-eight patients (female/male ratio: 9.8) had NMO. Age of onset in NMO patients was 30.9 years. Mean annual incidence of NMO in the French West Indies for the period July 2002 to June 2007 was 0.20/100,000 inhabitants (IC 95% 0.05-0.35). Incidence rates were steady in the FWI during the 1992 to 2007 period. Decreasing mortality in the FWI during the 1992 to 2007 period explained the increasing prevalence which was 4.20/100,000 inhabitants (IC 95% 3.7-5.7) in June 2007. The prevalence of NMO in Cuba on November302004 was 0.52/100,000 inhabitants. (IC 95% 0.39-0.67). Prevalence rates did not differ significantly by ethnic group in Cuba, however, black Cubans exhibited the highest prevalence.
Epidemiologic studies on NMO in each population are needed to determine whether aggressive therapies can reduce the mortality of this devastating disorder.
In the Caribbean basin, NMO involves almost exclusively young women; the epidemiologic data confirm its predilection for populations of African ancestry. In the FWI, recent and aggressive therapy has lowered mortality but with an increase in the prevalence of NMO.
上个世纪关于视神经脊髓炎（NMO）流行病学的数据仍然匮乏，但最近诊断标准的发展使得在流行病学研究中能够纳入单相和复发型NMO。鉴于NMO的罕见性，需要多中心研究来证实女性以及黑人/亚洲血统人群中推测的较高发病率。加勒比海地区是收集大型NMO队列并评估该疾病患病率、发病率和死亡率的合适地区。
这项基于人群的法属西印度群岛（FWI）和古巴NMO谱系调查纳入了151例病例。
98例患者（女性/男性比例为9.8）患有NMO。NMO患者的发病年龄为30.9岁。2002年7月至2007年6月期间法属西印度群岛NMO的年平均发病率为0.20/10万居民（95%可信区间0.05 - 0.35）。1992年至2007年期间法属西印度群岛的发病率保持稳定。1992年至2007年期间法属西印度群岛死亡率的下降解释了患病率的上升，2007年6月患病率为4.20/10万居民（95%可信区间3.7 - 5.7）。2004年11月30日古巴NMO的患病率为0.52/10万居民（95%可信区间0.39 - 0.67）。古巴不同种族群体的患病率差异不显著，然而，古巴黑人的患病率最高。
需要对每个群体进行NMO的流行病学研究，以确定积极治疗是否能降低这种毁灭性疾病的死亡率。
在加勒比海地区，NMO几乎只累及年轻女性；流行病学数据证实了其对非洲血统人群的偏好。在法属西印度群岛，近期的积极治疗降低了死亡率，但NMO的患病率有所上升。
