Prevalence of multiple sclerosis in key cities of Brazil. A study in Joinville, Southern Brazil.

Marcus Vinícius Magno Gonçalves,Rafaela Bittencourt Liberato,Rogério Rizo Morales,Claudio Henrique Do Amaral,Marco Aurélio Lana-Peixoto,Alexandre Luiz Longo,Áudred Cristina Biondo Eboni,Fábio Siquineli,Flavio Diniz Ribas,Paulo Roberto Wille,Edila Miers Chikota,Jefferson Becker

doi:10.1590/0004-282x-anp-2020-0101

Abstract

The Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS) has launched an initiative to determine the prevalence of multiple sclerosis (MS) in Brazil, based on key cities deemed representative of their regions in terms of demographic and environmental features. To investigate the prevalence rate of MS in Joinville. We reviewed the medical records of all patients who lived in Joinville and met the 2010 McDonald's diagnostic criteria revised for MS on the prevalence day (March 11, 2016). Potential MS patients included individuals treated by all practicing neurologists in the city and the ones found in patients' association and the database of the Municipal Department of Health. Advertisements about the survey were also broadcast on radio and television. Patients who were not living in Joinville on the prevalence day were excluded. All potential MS patients were invited to an in-person diagnostic review, carried out by a panel of experienced neurologists with special expertise in MS on March 11, 2016. The MS prevalence rate was 13.5 per 100,000 inhabitants (95% confidence interval [95%CI] 12.9-14.0/100,000). A total of 51 (66.2%) participants were females, and 26 (33.7%) were males (female to male ratio=1.9:1). Out of the 77 patients, 73 (94.8%) were Caucasians, and four (5.1%) were mixed-race. Despite its latitude location and European colonization, the prevalence rate was below expectation. The intense internal migration from regions with lower MS prevalence rates to Joinville may have played a role in attenuating the increased risk of MS associated with latitude gradient and European ancestry. Prevalence studies in other cities from Southern Brazil with no significant internal migration and taking part in this broad project may clarify this issue.

Highlights

Multiple sclerosis (MS) is the most prevalent chronic inflammatory autoimmune disease of the central nervous system (CNS)[1,2]
In addition to medical records from all practicing neurologists in Joinville at the time of the study, we consulted the database of the Municipal Department of Health, which is responsible for providing disease-modifying therapy (DMT) for most multiple sclerosis (MS) patients living in the city, as well as the membership list of the local MS patient association
The results show that the MS prevalence rate in the city of Joinville is 13.5 per 100,000 inhabitants

Summary

Introduction

Multiple sclerosis (MS) is the most prevalent chronic inflammatory autoimmune disease of the central nervous system (CNS)[1,2]. Given the marked heterogeneity of methods employed across studies, a nationwide distribution of MS prevalence in the country and an accurate comparison between the prevalence rates in different regions of Brazil are not yet available In this context, the Brazilian Committee for Treatment and Research in MS (BCTRIMS) has launched an initiative to determine the prevalence of MS in Brazil, based on key cities deemed representative of their regions in terms of demographic and environmental features. Methods: We reviewed the medical records of all patients who lived in Joinville and met the 2010 McDonald’s diagnostic criteria revised for MS on the prevalence day (March 11, 2016). The intense internal migration from regions with lower MS prevalence rates to Joinville may have played a role in attenuating the increased risk of MS associated with latitude gradient and European ancestry. Prevalence studies in other cities from Southern Brazil with no significant internal migration and taking part in this broad project may clarify this issue

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