MS prevalence in New Zealand, an ethnically and latitudinally diverse country.
BACKGROUND
The prevalence of multiple sclerosis (MS) is not uniform, with a latitudinal gradient of prevalence present in most studies. Understanding the drivers of this gradient may allow a better understanding of the environmental factors involved in MS pathogenesis.


METHODS
The New Zealand national MS prevalence study (NZMSPS) is a cross-sectional study of people with definite MS (DMS) (McDonald criteria 2005) resident in New Zealand on census night, 7 March 2006, utilizing multiple sources of notification. Capture-recapture analysis (CRA) was used to estimate missing cases.


RESULTS
Of 2917 people with DMS identified, the crude prevalence was 72.4 per 100,000 population, and 73.1 per 100,000 when age-standardized to the European population. CRA estimated that 96.7% of cases were identified. A latitudinal gradient was seen with MS prevalence increasing three-fold from the North (35°S) to the South (48°S). The gradient was non-uniform; females with relapsing-remitting/secondary-progressive (RRMS/SPMS) disease have a gradient 11 times greater than males with primary-progressive MS (p < 1 × 10(-7)). DMS was significantly less common among those of Māori ethnicity.


CONCLUSIONS
This study confirms the presence of a robust latitudinal gradient of MS prevalence in New Zealand. This gradient is largely driven by European females with the RRMS/SPMS phenotype. These results indicate that the environmental factors that underlie the latitudinal gradient act differentially by gender, ethnicity and MS phenotype. A better understanding of these factors may allow more targeted MS therapies aimed at modifiable environmental triggers at the population level.
Taylor
Bruce V
BV
Menzies Research Institute, University of Tasmania, Hobart, Australia. bruce.taylor@utas.edu.au
Pearson
John F
JF
Clarke
Glynnis
G
Mason
Deborah F
DF
Abernethy
David A
DA
Willoughby
Ernie
E
Sabel
Clive
C
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology*; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors