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. 2004 Apr;75(4):572–576. doi: 10.1136/jnnp.2003.012666

Latitudinal variation in the prevalence of multiple sclerosis in Ireland, an effect of genetic diversity

C McGuigan 1, A McCarthy 1, C Quigley 1, L Bannan 1, S Hawkins 1, M Hutchinson 1
PMCID: PMC1739004  PMID: 15026499

Abstract

Background: Northern Ireland has a high and rising prevalence rate of multiple sclerosis (MS). The most recent survey in 1996 found a rate of 168.7/100 000. Recorded prevalence rates for the south of Ireland, including County Wexford, have been markedly lower and seemed to suggest the existence of a prevalence gradient within the island.

Objectives: To compare the prevalence of multiple sclerosis in Co. Wexford in the south east of Ireland and Co. Donegal in the north west, and to establish whether a variation in prevalence of MS exists within Ireland.

Methods: Patients were referred from multiple sources. Review of clinical case records and/or patient examination confirmed the diagnosis.

Results: In Co. Wexford, 126 patients were found to have clinically definite or probable multiple sclerosis with a prevalence rate of 120.7/100 000 (95% confidence intervals (CI) 100.6 to 143.8), which is similar to other areas of similar latitude within the British Isles. In Co. Donegal, 240 people had clinically definite or probable MS with a prevalence rate of 184.6/100 000 (95% CI 162.0 to 209.5). The difference in prevalence rates is statistically significant (Z = 3.94, p = <0.001).

Conclusion: There is a latitudinal variation in the prevalence rate of MS between the north and the south of Ireland. The increased prevalence of MS seen in Co. Wexford is likely to represent better case ascertainment and improved diagnostic accuracy rather than an actual increase in prevalence. The north/south variation in prevalence may represent a variation in the genetic predisposition to MS between the background populations of the two counties.

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Selected References

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  1. ALLISON R. S., MILLAR J. H. Prevalence of disseminated sclerosis in Northern Ireland. Ulster Med J. 1954 Mar;23(Suppl 2):1–27. [PMC free article] [PubMed] [Google Scholar]
  2. Brady R., Dean G., Secerbegovic S., Secerbegovic A. M. Multiple sclerosis in the Republic of Ireland. Ir Med J. 1977 Nov 18;70(17):500–506. [PubMed] [Google Scholar]
  3. Cook S. D., Cromarty J. I., Tapp W., Poskanzer D., Walker J. D., Dowling P. C. Declining incidence of multiple sclerosis in the Orkney Islands. Neurology. 1985 Apr;35(4):545–551. doi: 10.1212/wnl.35.4.545. [DOI] [PubMed] [Google Scholar]
  4. Cook S. D., MacDonald J., Tapp W., Poskanzer D., Dowling P. C. Multiple sclerosis in the Shetland Islands: an update. Acta Neurol Scand. 1988 Feb;77(2):148–151. doi: 10.1111/j.1600-0404.1988.tb05885.x. [DOI] [PubMed] [Google Scholar]
  5. Cutter G. R., Baier M. L., Rudick R. A., Cookfair D. L., Fischer J. S., Petkau J., Syndulko K., Weinshenker B. G., Antel J. P., Confavreux C. Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain. 1999 May;122(Pt 5):871–882. doi: 10.1093/brain/122.5.871. [DOI] [PubMed] [Google Scholar]
  6. Forbes R. B., Swingler R. J. An epidemiologic study of multiple sclerosis in Northern Ireland. Neurology. 1999 Jan 1;52(1):215–216. doi: 10.1212/wnl.52.1.214-a. [DOI] [PubMed] [Google Scholar]
  7. Forbes R. B., Swingler R. J. Estimating the prevalence of multiple sclerosis in the United Kingdom by using capture-recapture methodology. Am J Epidemiol. 1999 Jun 1;149(11):1016–1024. doi: 10.1093/oxfordjournals.aje.a009746. [DOI] [PubMed] [Google Scholar]
  8. Forbes R. B., Wilson S. V., Swingler R. J. The prevalence of multiple sclerosis in Tayside, Scotland: do latitudinal gradients really exist? J Neurol. 1999 Nov;246(11):1033–1040. doi: 10.1007/s004150050509. [DOI] [PubMed] [Google Scholar]
  9. Hammond S. R., McLeod J. G., Millingen K. S., Stewart-Wynne E. G., English D., Holland J. T., McCall M. G. The epidemiology of multiple sclerosis in three Australian cities: Perth, Newcastle and Hobart. Brain. 1988 Feb;111(Pt 1):1–25. doi: 10.1093/brain/111.1.1. [DOI] [PubMed] [Google Scholar]
  10. Hennessy A., Swingler R. J., Compston D. A. The incidence and mortality of multiple sclerosis in south east Wales. J Neurol Neurosurg Psychiatry. 1989 Sep;52(9):1085–1089. doi: 10.1136/jnnp.52.9.1085. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hook E. B., Regal R. R. The value of capture-recapture methods even for apparent exhaustive surveys. The need for adjustment for source of ascertainment intersection in attempted complete prevalence studies. Am J Epidemiol. 1992 May 1;135(9):1060–1067. doi: 10.1093/oxfordjournals.aje.a116400. [DOI] [PubMed] [Google Scholar]
  12. Hutchinson M. Disability due to multiple sclerosis: a community-based study on an Irish county. Ir Med J. 1986 Feb;79(2):48–50. [PubMed] [Google Scholar]
  13. Kurtzke J. F. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983 Nov;33(11):1444–1452. doi: 10.1212/wnl.33.11.1444. [DOI] [PubMed] [Google Scholar]
  14. Lockyer M. J. Prevalence of multiple sclerosis in five rural Suffolk practices. BMJ. 1991 Aug 10;303(6798):347–348. doi: 10.1136/bmj.303.6798.347. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McDonald W. I., Halliday A. M. Diagnosis and classification of multiple sclerosis. Br Med Bull. 1977 Jan;33(1):4–9. [PubMed] [Google Scholar]
  16. McDonnell G. V., Hawkins S. A. An epidemiologic study of multiple sclerosis in Northern Ireland. Neurology. 1998 Feb;50(2):423–428. doi: 10.1212/wnl.50.2.423. [DOI] [PubMed] [Google Scholar]
  17. Mumford C. J., Fraser M. B., Wood N. W., Compston D. A. Multiple sclerosis in the Cambridge health district of east Anglia. J Neurol Neurosurg Psychiatry. 1992 Oct;55(10):877–882. doi: 10.1136/jnnp.55.10.877. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Poser C. M., Paty D. W., Scheinberg L., McDonald W. I., Davis F. A., Ebers G. C., Johnson K. P., Sibley W. A., Silberberg D. H., Tourtellotte W. W. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983 Mar;13(3):227–231. doi: 10.1002/ana.410130302. [DOI] [PubMed] [Google Scholar]
  19. Rice-Oxley M., Williams E. S., Rees J. E. A prevalence survey of multiple sclerosis in Sussex. J Neurol Neurosurg Psychiatry. 1995 Jan;58(1):27–30. doi: 10.1136/jnnp.58.1.27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Roberts M. H., Martin J. P., McLellan D. L., McIntosh-Michaelis S. A., Spackman A. J. The prevalence of multiple sclerosis in the Southampton and South West Hampshire Health Authority. J Neurol Neurosurg Psychiatry. 1991 Jan;54(1):55–59. doi: 10.1136/jnnp.54.1.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Robertson N., Compston A. Surveying multiple sclerosis in the United Kingdom. J Neurol Neurosurg Psychiatry. 1995 Jan;58(1):2–6. doi: 10.1136/jnnp.58.1.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Robertson N., Deans J., Fraser M., Compston D. A. Multiple sclerosis in south Cambridgeshire: incidence and prevalence based on a district register. J Epidemiol Community Health. 1996 Jun;50(3):274–279. doi: 10.1136/jech.50.3.274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Robertson N., Deans J., Fraser M., Compston D. A. Multiple sclerosis in the north Cambridgeshire districts of East Anglia. J Neurol Neurosurg Psychiatry. 1995 Jul;59(1):71–76. doi: 10.1136/jnnp.59.1.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rothwell P. M., Charlton D. High incidence and prevalence of multiple sclerosis in south east Scotland: evidence of a genetic predisposition. J Neurol Neurosurg Psychiatry. 1998 Jun;64(6):730–735. doi: 10.1136/jnnp.64.6.730. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Sharpe G., Price S. E., Last A., Thompson R. J. Multiple sclerosis in island populations: prevalence in the Bailiwicks of Guernsey and Jersey. J Neurol Neurosurg Psychiatry. 1995 Jan;58(1):22–26. doi: 10.1136/jnnp.58.1.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Shepherd D. I., Downie A. W. A further prevalence study of multiple sclerosis in north-east Scotland. J Neurol Neurosurg Psychiatry. 1980 Apr;43(4):310–315. doi: 10.1136/jnnp.43.4.310. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Shepherd D. I., Summers A. Prevalence of multiple sclerosis in Rochdale. J Neurol Neurosurg Psychiatry. 1996 Oct;61(4):415–417. doi: 10.1136/jnnp.61.4.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Skegg D. C., Corwin P. A., Craven R. S., Malloch J. A., Pollock M. Occurrence of multiple sclerosis in the north and south of New Zealand. J Neurol Neurosurg Psychiatry. 1987 Feb;50(2):134–139. doi: 10.1136/jnnp.50.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Swingler R. J., Compston D. The distribution of multiple sclerosis in the United Kingdom. J Neurol Neurosurg Psychiatry. 1986 Oct;49(10):1115–1124. doi: 10.1136/jnnp.49.10.1115. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wittes J. T., Colton T., Sidel V. W. Capture-recapture methods for assessing the completeness of case ascertainment when using multiple information sources. J Chronic Dis. 1974 Feb;27(1):25–36. doi: 10.1016/0021-9681(74)90005-8. [DOI] [PubMed] [Google Scholar]
  31. Zivadinov Robert, Iona Leo, Monti-Bragadin Luisa, Bosco Antonio, Jurjevic Ante, Taus Cristina, Cazzato Giuseppe, Zorzon Marino. The use of standardized incidence and prevalence rates in epidemiological studies on multiple sclerosis. A meta-analysis study. Neuroepidemiology. 2003 Jan-Feb;22(1):65–74. doi: 10.1159/000067107. [DOI] [PubMed] [Google Scholar]

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