title: Multiple sclerosis in Jordan: A clinical and epidemiological study.
abstract: OBJECTIVE
  To characterize the clinical, demographic and epidemiological features of multiple sclerosis (MS) in Jordan.
  
  
  METHODS
  Data for consecutive Jordanian patients, fulfilling the McDonald criteria for clinically definite and clinically probable MS, during the time period 2004-2005 were collected and analyzed in the three major referral centers for MS in Jordan.
  
  
  RESULTS
  We identified a total of 224 patients (165 females, 87%; 59 males, 13%). The mean (+/-SD) age of onset was 29.3 (+/-9.6) years, and mean (+/-SD) duration of illness was 3.9 (+/-9.3) years. The prevalence of MS in the city of Amman was 39/100,000. The prevalence of MS in Irbid, north Jordan, was 38/100,000. The most frequent presentation was weakness (30.8%), followed by optic neuritis (20.1%), sensory impairment (19.6%), and ataxia (14.3%). A relapsing remitting pattern was identified in 90.2% of patients, the rest being primary and secondary progressive, and one patient had a progressive relapsing course. Family history of MS was found in 9.4% of the cases. About 60% of the patients were using interferon beta. The degree of physical disability was determined using the Expanded Disability Status Scale (EDSS). Younger age of onset, shorter duration of illness, a relapsing remitting pattern, and use of interferon were identified as statistically significant predictors of less disability.
  
  
  CONCLUSIONS
  Jordan is a medium-high risk country for MS, with prevalence higher than what has previously been reported, possibly representing an increase in incidence. Clinical and demographic characteristics are similar to most reports worldwide.
authors.affiliation: Department of Neurosciences, Jordan University of Science and Technology, College of Medicine, King Abdulla University Hospital, PO Box 3030, Irbid 22110, Jordan. khalidelsalem@hotmail.com
authors.forename: Khalid
authors.initials: K
authors.lastname: El-Salem
authors.forename: Ehsan
authors.initials: E
authors.lastname: Al-Shimmery
authors.forename: Khalid
authors.initials: K
authors.lastname: Horany
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Refai
authors.forename: Kefah
authors.initials: K
authors.lastname: Al-Hayk
authors.forename: Yousef
authors.initials: Y
authors.lastname: Khader
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003710:Demography; D004185:Disability Evaluation; D018450:Disease Progression; D015991:Epidemiologic Measurements; D005260:Female; D006801:Humans; D007597:Jordan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors