Sharp increase in the incidence and prevalence of multiple sclerosis in Isfahan, Iran

Masoud Etemadifar1,3
Amir-Hadi Maghzi1,2? Maghzi at edc.mui.ac.ir
1 Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK.
3 Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran.

Amir-Hadi Maghzi, Isfahan Research Committee of Multiple Sclerosis (IRCOMS), Multiple Sclerosis Clinic, Al-Zahra Hospital, Isfahan University of Medical Sciences, Soffeh Street, Isfahan 81744, Iran
Mult Scler August 2011 vol. 17 no. 8 1022-1027

Background: The epidemiology of multiple sclerosis (MS) has changed in recent decades.

Objectives: This study aimed to give an update on the prevalence and incidence of MS in Isfahan, Iran.

Methods: The study population was all residents of Isfahan province during the period from April 2003 to July 2010. In April 2003, a registry of MS patients was created at the Isfahan MS Society (IMSS), which is the only referral center for MS patients in the province. Nearly all MS patients in Isfahan province are now registered with IMSS and were included in the analysis.

Results: Among the 3522 registered patients, 2716 were female and 806 were male (sex ratio: 3.37?:?1), and 431 were diagnosed in 2009. This results in a prevalence figure of 73.3 (95% CI: 70.9–75.8) and an incidence of 9.1 (95% CI: 8.3–10.0) per 100,000.

Conclusion: The reported prevalence and incidence figures in our study were higher than in our previous report of 2007, in which the prevalence and incidence of MS were reported to be 43.8 and 3.64 per 100,000, respectively. This dramatic increase in the prevalence of MS puts Isfahan amongst the regions with the highest prevalence of MS in Asia and Oceania and is mostly due to changing environmental factors, amongst which vitamin D deficiency seems an important factor in our population.

Received July 29, 2010; Revision received November 18, 2010; Revision received January 29, 2011; Accepted January 30, 2011.
– – – – – –

Prevalence 44 in 2007 ==> 73 in 2009 =current number of people suffering from MS

Incidence 3.6 in 2007==> 9.1 in 2009 = measure of new cases

In 2 years the number of new cases of MS increased 2.5 = 9.1/3.69

Population of Isfahan province 2006 =2.9 million urban + 1 million rural

VitaminDWiki suspects that the vitamin D deficiency is due to several of the 11 new reasons for vitamin D deficiency

• 1) Air conditioning - to avoid the hot sun
• 2) Indoor multimedia
• 3) Indoor jobs
• 4) Living in cities - where there is less UV, and a greater tendency to wear heavy clothing
• 5) Want whiter skin - especially women– no longer a “healthy tan”

Everything on this map is North of the Equator

See also VitaminDWiki

• Overview MS and Vitamin D
• 23 ng of vitamin D in sunny Israel – Dec 2010
• High Prevalence of Vitamin D Insufficiency in Athletes and Dancers in Israel
• Ultra-orthodox jews also suffer from 10 ng vitamin D levels – Nov 2010 clothing restricts access to the sun
• Arab pre-term infants often have less than 10 ng of vitamin D - 2010
• Air Conditioning probably has decreased vitamin D from a book
• Diabetes rising quickly in areas with recent air conditioning – June 2011
• Hypothesis – China air conditioning disease is the result of less vitamin D – March 2011
• Even in Sunny Areas, Vitamin D Intake Often Too Low - May 2010
• Less than 4 ng is more common in Saudis than diabetic Saudis – July 2010
• Parkinson disease increased in Israel by 50 percent in 7 years – June 2011
• Iranian vitamin D levels 13 ng summer, 12 ng winter – June 2011
• Need to avoid the sun during the summer in Duhai