Mousavizadeh A, Dastoorpoor M, Naimi E, Dohrabpour K
Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
Department of Epidemiology and Biostatistics, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Public Health. 2018 Jan;154:14-23. doi: 10.1016/j.puhe.2017.10.003. Epub 2017 Nov 10.
This study was designed and implemented to assess the current situation and to estimate the time trend of multiple sclerosis (MS), as well as to explain potential factors associated with such a trend.
This longitudinal study was carried out based on analysis of the data from the monitoring and treatment surveillance system for 421 patients with MS in Kohgiluyeh and Boyer-Ahmad Province, Iran, from 1990 to 2015. To this end, curve estimation approach was used to investigate the changes in prevalence and incidence of the disease, and univariate time series model analysis was applied in order to estimate the disease incidence in the next 10 years.
The mean and standard deviation of age were 29.78 and 8.5 years at the time of diagnosis, and the mean and 95% confidence interval of age were 29.18 (28.86-30.77) and 29.68 (28.06-31.30) at the time of diagnosis for women and men, respectively. The sex ratio (males to females) was estimated as 3.3, and the prevalence of the disease was estimated as 60.14 in 100,000 people. The diagram of the 35-year trend of the disease indicated three distinct patterns with a tendency to increase in recent years.
The prevalence and incidence trend of the disease in the study population is consistent with regional and global changes. Climatic and environmental factors such as extreme weather changes, dust particles, expansion of the application of new industrial materials, and regional wars with potential use of banned weapons are among the issues that may, in part, be able to justify the global and regional changes of the disease. Predictive models indicate a growing trend of the disease, highlighting the need for more regular monitoring of the disease trend in upcoming years.
本研究旨在评估多发性硬化症(MS)的现状并估计其时间趋势,同时解释与该趋势相关的潜在因素。
本纵向研究基于对1990年至2015年伊朗科吉卢耶-博韦艾哈迈德省421例MS患者的监测和治疗监测系统数据进行分析。为此,采用曲线估计方法研究疾病患病率和发病率的变化,并应用单变量时间序列模型分析来估计未来10年的疾病发病率。
诊断时年龄的均值和标准差分别为29.78岁和8.5岁,女性和男性诊断时年龄的均值及95%置信区间分别为29.18(28.86 - 30.77)和29.68(28.06 - 31.30)。男女比例估计为3.3,疾病患病率估计为每10万人中有60.14例。该疾病35年趋势图显示出三种不同模式,近年来有上升趋势。
研究人群中该疾病的患病率和发病率趋势与区域及全球变化一致。极端天气变化、尘埃颗粒、新型工业材料应用的扩大以及可能使用违禁武器的地区战争等气候和环境因素,可能在一定程度上解释了该疾病的全球和区域变化。预测模型表明该疾病呈增长趋势,凸显了在未来几年更定期监测疾病趋势的必要性。