title: Environmental changes and epidemiology of multiple sclerosis in the French West Indies.
abstract: Multiple sclerosis (MS) emerged in the French West Indies (Martinique and Guadeloupe) at the beginning of the 1990s with an incidence for the period 1992-2007 of 1.27/100,000 (95% CI, 1.16-1.38). Its incidence, which is continuously increasing, reached 2.27/100,000 (95% CI, 1.92-2.62) in Martinique for the period 2002-07. Neuromyelitis optica (NMO), in contrast, has a stable incidence of 0.19/100,000 (95% CI, 0.15-0.23) resulting in a gradual increase in the MS/NMO ratio, which was 8.35 for the period 2002-07. MS initially affected the female population with a female/male incidence ratio of 8.43 for the period 1992-97, which gradually fell to 2.63 for the period 2002-07 due to the increased incidence of MS in men. Several environmental factors are involved in the emergence of MS: (1) the migration of the French West Indian population to mainland France resulted in an excess incidence of MS in the migrants; (2) a decrease in sun exposure, a risk factor for MS, related to the changing lifestyle of the French West Indian population has been demonstrated in a case-control study; (3) at ecological level, enhanced hygiene associated with the eradication of intestinal helminthiases, known to induce immune system tolerance, is also strongly suspected with regard to MS emergence.
authors.affiliation: Service de Neurologie, CHU Fort de France, Hôpital Pierre Zobda Quitman, Fort de France, Martinique, France. pcabre_fr@yahoo.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Cabre
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D016001:Confidence Intervals; D004777:Environment; D005260:Female; D019430:Guadeloupe / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000209:etiology*; D009471:Neuromyelitis Optica / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012737:Sex Factors; D012744:Sex Ratio; D055815:Young Adult