title: High prevalence and fast rising incidence of multiple sclerosis in Caltanissetta, Sicily, southern Italy.
abstract: BACKGROUND
  Epidemiological studies conducted in Sicily and Sardinia, the two major Mediterranean islands, showed elevated incidence and prevalence of multiple sclerosis (MS)and a recent increase in disease frequency.
  
  
  OBJECTIVE
  To confirm the central highlands of Sicily as areas of increasing MS prevalence and elevated incidence, we performed a follow-up study based on the town of Caltanissetta (Sicily), southern Italy.
  
  
  METHODS
  We made a formal diagnostic reappraisal of all living patients found in the previous study performed in 1981. All possible information sources were used to search for patients affected by MS diagnosed according to the Poser criteria. We calculated prevalence ratios, for patients affected by MS who were living and resident in the study area on December 31, 2002. Crude and age- and sex-specific incidence ratios were computed for the period from January 1, 1993, to December 31, 2002.
  
  
  RESULTS
  The prevalence of definite MS rose in 20 years from 69.2 (retrospective prevalence rate) to 165.8/100,000 population. We calculated the incidence of definite MS for the period 1970-2000. These rates calculated for 5-year periods increased from 2.3 to 9.2/100,000/year.
  
  
  CONCLUSIONS
  This survey shows the highest prevalence and incidence figures of MS in the Mediterranean area and confirms central Sicily as a very-high-risk area for MS.
authors.affiliation: Unità Operativa di Neurologia, Fondazione Istituto San Raffaele G. Giglio, Cefalù, Italia.
authors.forename: Luigi M E
authors.initials: LM
authors.lastname: Grimaldi
authors.forename: Barbara
authors.initials: B
authors.lastname: Palmeri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salemi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giglia
authors.forename: Marco
authors.initials: M
authors.lastname: D'Amelio
authors.forename: Roberto
authors.initials: R
authors.lastname: Grimaldi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Vitello
authors.forename: Paolo
authors.initials: P
authors.lastname: Ragonese
authors.forename: Giovanni
authors.initials: G
authors.lastname: Savettieri
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D015995:Prevalence; D017678:Sex Distribution; D012802:Sicily / Q000453:epidemiology; D014504:Urban Health