Multiple sclerosis in KwaZulu Natal, South Africa: an epidemiological and clinical study
Multiple sclerosis in KwaZulu Natal, South Africa: an epidemiological and clinical study
复制标题
DOI：
10.1177/1352458507079274
复制
发表时间：
2007-11-01
影响因子：
5.8
通讯作者：
Romkissoon, K.
中科院分区：
文献类型：
--
作者：
Bhigjee, Al;Moodley, K.;Romkissoon, K.
自Dean的研究以来，大约40年前，南非还没有使用现代诊断标准对多发性硬化症（MS）患病率进行系统的研究。夸祖鲁-纳塔尔省（KZN）是南非九个省之一，拥有990万不同种族的人口。目的采用修订后的麦当劳标准，确定不同种族人群中KZN多发性硬化症的时期患病率。方法回顾性分析所有确诊为多发性硬化症的KZN患者的病历，以确定诊断。在一个月的时间内（2005年7月）对所有患者进行电话联系，以确定他们是否仍然活着并仍然居住在KZN。临床、实验室和治疗数据也从图表中提取。结果白人粗期患病率为25.63 / 10万，印第安人7.59 / 10万，混血儿1.94 / 10万，黑人0.22 / 10万。相应的年龄标准化患病率分别为25.64、7.15、1.72、0.23 / 10万。临床特征与西方世界相似。167例患者中多达一半有明显的运动障碍，43/167（25.7%）的患者出现视神经炎。虽然所有可追踪的MRI脑部扫描都显示出一些异常，但139人中有96人（69.1%）符合麦当劳MRI四项标准中的三项。124个检测样本中有102个（82.3%）存在CSF寡克隆条带。结论KZN地区多发性硬化症的发病率高于以往的估计，在所有种族中均有发生，以白人居多，其次为印度人。多发性硬化症虽然罕见，但确实发生在黑人身上。增加的患病率数字可能反映了更好的病例确定和现代诊断技术的使用。然而，不能排除人数绝对增加的可能性。
Background Since the study by Dean, almost 40 years ago, there has been no systematic South African study on the prevalence of multiple sclerosis (MS) using the modern diagnostic criteria. KwaZulu-Natal (KZN), one of the nine provinces in South Africa, is home to 9.9 million people belonging to all racial groups.Aim To determine the period prevalence of MS in KZN in the different racial groups, using the revised McDonald's criteria.Methods The charts of all KZN patients given the diagnosis of MS were reviewed to confirm the diagnosis. All patients were contacted telephonically over a period of one month (July 2005) to determine whether they were still alive and still resident in KZN. Clinical, laboratory and treatment data were also extracted from the charts.Results The crude period prevalence per 100 000 for whites was 25.63, for Indians 7.59, people of mixed ancestry 1.94 and for blacks 0.22. The corresponding age standardized prevalence per 100000 were 25.64, 7.15, 1.72 and 0.23, respectively. The clinical features were similar to that seen in the Western world. Up to half of the 167 patients had significant motor disability and optic neuritis was seen in 43/167 (25.7%) of patients. Whilst all traceable MRI brain scans showed some abnormality, 96/139 (69.1 %) met three of the four McDonald's MRI criteria. CSF oligoclonal bands were present in 102 of 124 (82.3%) samples tested.Conclusion MS in KZN is more frequent than previously believed and occurs in all racial groups being most frequent in whites followed by Indians. MS, although rare, does occur in blacks. The increased prevalence figures may reflect better case ascertainment and use of modern diagnostic techniques. However, an absolute increase in numbers cannot be excluded.