Multiple sclerosis in Västerbotten county, northern Sweden

• Main Author: Sundström, Peter
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Umeå universitet, Klinisk neurovetenskap 2003
• Subjects: multiple sclerosis; epidemiology; prevalence; incidence; onset symptoms; disability; sick leave; professional assistance; Epstein-Barr virus; and HHV-6; Behavioral Sciences Biology; Etologi; Northern Sweden
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-140313

One out of several distinguishing features of multiple sclerosis (MS) is the epidemiological variation of geographic distribution. Population-based studies on the prevalence and incidence of MS in Sweden have previously been performed only in Göteborg. Another feature of MS is the clinical variation between individuals. To a large extent data on the clinical characteristics of MS come from studies on cases frequenting MS clinics and therefore, may be biased. Also rare are population-based studies of the consequences of MS-related incapacity on socio­economic factors. As for MS aetiology, both environment and genes are involved. Human herpesviruses are often the main suspected environmental aetiological agents. Our aim was to estimate the prevalence of MS in Västerbotten County for 1 January 1990, the incidence during a 10-year period 1988-97, and the prevalence 31 December 1997; and also to present detailed clinical data including onset symptoms and the disability distribution for the latter two MS populations. Furthermore, we wanted to estimate the prevalence of sick leave, professional assistance, and housing; and also, to study the risk factors for sick leave. In order to investigate the association between MS and human herpesviruses, samples were identified in two regional population-based serumbank registers. This linkage identified samples collected from before MS-onset in 73 MS cases and after MS onset in 161 cases The prevalence and incidence populations were identified through multiple sources. Diagnostic ascertainment, the reliability of clinical data, and additional information were assured from a questionnaire with follow-up interview and neurological examination. The onset adjusted crude prevalence of MS was 125/100,000 (95% CI: 112-140) in January 1990, and 154/100,000 (95% Cl: 139-170) in December 1997. The increase was mainly attributable to a higher incidence than mortality. The crude incidence rate 1988-97 was 5.2/100,000 (95% CI: 4.4-6.2). The disability distribution in the 1997 prevalence ...