title: Multiple sclerosis in the Republic of San Marino: a prevalence and incidence study.
abstract: Studies on the distribution of multiple sclerosis (MS) carried out in Southern Europe in the last years have shown a significant increase in the frequency of the disease. A previous descriptive survey in the Republic of San Marino, northern Italian peninsula, published in 1984 established that this area is at high risk for MS. We updated the frequency estimates of the disease by adopting a complete enumeration approach. On 31 December 2005, 50 MS patients (36 women and 14 men) yielded a crude prevalence rate of 166.7 per 100, 000 (95% CI 123.7-220), 235.3 (95% CI 165-327.4) for women and 95.2 (95% CI 52-160) for men. The average incidence from 1990 to 2005 was 7.9 (95% CI 5.3-11.1) per 100,000, 11.7 (95% CI 7.6-17.3) for women and 3.9 (95% CI 1.7-7.7) for men. We did not detect any significant temporal trend over the study period. These results confirm that in San Marino the disease occurs more frequently than that suggested in the past and support the data on MS frequency in continental Italy. The marked increase in MS prevalence ratio is partly due to the increasing survival of patients and the accumulation of new incidence cases owing to the reduction in diagnostic latency for better quality of neurological diagnostic procedures. However, an increased incidence of the disease could be considered.
authors.affiliation: Sezione di Clinica Neurologica, Dipartimento di Discipline Medico-Chirurgiche della Comunicazione e del Comportamento, Centro Sclerosi Multipla, University of Ferrara, Italy. enrico.granieri@unife.it
authors.forename: E
authors.initials: E
authors.lastname: Granieri
authors.forename: C
authors.initials: C
authors.lastname: Monaldini
authors.forename: R
authors.initials: R
authors.lastname: De Gennaro
authors.forename: S
authors.initials: S
authors.lastname: Guttmann
authors.forename: M
authors.initials: M
authors.lastname: Volpini
authors.forename: M
authors.initials: M
authors.lastname: Stumpo
authors.forename: P
authors.initials: P
authors.lastname: Fazio
authors.forename: I
authors.initials: I
authors.lastname: Casetta
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000453:epidemiology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology*; D015995:Prevalence; D012496:San Marino / Q000453:epidemiology; D017678:Sex Distribution