Hosseinzadeh Ali, Sedighi Behnaz, Kermanchi Jamshid, Heidari Mohammad, Haghdoost Ali Akbar
Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
Neurology Research Center, Kerman University of Medical Science, Kerman, Iran.
BMC Neurol. 2021 Jan 7;21(1):7. doi: 10.1186/s12883-020-02031-5.
Some epidemiologic studies have reported a sharp increase in multiple sclerosis (MS) incidence in different provinces in Iran. This report aimed to investigate more closely the increasing trend of MS incidence in the past 10 years in Iran.
In this longitudinal study, the data for all MS patients meeting the McDonald criteria were obtained from a national registry, coordinated by the Ministry of Health (MOH). Joinpoint (JP) regression was used for time trend analysis of MS incidence and determine the optimal number of significant joinpoints. Finally, an annual percentage change (APC) in MS incidence for each segment of the trend line was estimated with 95% confidence interval.
The mean age of the patients and the mean annual incidence rate of MS were 30.9 ± 1.1 and 5.3 ± 1.9 per 100,000 population, respectively. The overall incidence rate of MS had increased significantly from 2.14 in 2006 to its peak (7.5) in 2014, per 100,000 population (APC = 12%, P < 0.001). The first JP was observed in 2011 in both male and female groups. The overall APC in the first segment was 22.6% (17.2-28.2%, p < 0.01). Besides, the corresponding APC values for males and females were 22.1% (14.7-30%, p < 0.01) and 22.5% (17.5-27.8%, p < 0.01), respectively. After 2011, the MS incidence underwent a more or less decreasing trend in both genders.
Contrary to previous studies, the MS incidence trend in Iran was rising just before 2011, and in the recent decade, Iran has a stable rate of MS cases.
一些流行病学研究报告称，伊朗不同省份的多发性硬化症（MS）发病率急剧上升。本报告旨在更密切地调查伊朗过去10年MS发病率的上升趋势。
在这项纵向研究中，所有符合麦克唐纳标准的MS患者的数据均来自由卫生部（MOH）协调的国家登记处。采用Joinpoint（JP）回归对MS发病率进行时间趋势分析，并确定显著连接点的最佳数量。最后，估计趋势线各段MS发病率的年度百分比变化（APC）及其95%置信区间。
患者的平均年龄和MS的平均年发病率分别为30.9±1.1岁和每10万人中5.3±1.9例。MS的总体发病率已从2006年的每10万人中2.14例显著增加到2014年的峰值（7.5例）（APC=12%，P<0.001）。在男性和女性组中，第一个连接点均出现在2011年。第一段的总体APC为22.6%（17.2-28.2%，p<0.01）。此外，男性和女性的相应APC值分别为22.1%（14.7-30%，p<0.01）和22.5%（17.5-27.8%，p<0.01）。2011年后，男女MS发病率均呈或多或少的下降趋势。
与先前的研究相反，伊朗的MS发病率在2011年前呈上升趋势，且在最近十年中，伊朗的MS病例数保持稳定。
