title: Prevalence of multiple sclerosis in the Lazio region, Italy: use of an algorithm based on health information systems.
abstract: Compared with other areas of the country, very limited data are available on multiple sclerosis (MS) prevalence in Central Italy. We aimed to estimate MS prevalence in the Lazio region and its geographical distribution using regional health information systems (HIS). To identify MS cases we used data from drug prescription, hospital discharge and ticket exemption registries. Crude, age- and gender-specific prevalence estimates on December 31, 2011 were calculated. To compare MS prevalence between different areas within the region, we calculated age- and gender-adjusted prevalence and prevalence ratios using a multivariate Poisson regression model. Crude prevalence rate was 130.5/100,000 (95 % CI 127.5-133.5): 89.7/100,000 for males and 167.9/100,000 for females. The overall prevalence rate standardized to the European Standard Population was 119.6/100,000 (95 % CI 116.8-122.4). We observed significant differences in MS prevalence within the region, with estimates ranging from 96.3 (95 % CI 86.4-107.3) for Latina to 169.6 (95 % CI 147.6-194.9) for Rieti. Most districts close to the coast showed lower prevalence estimates compared to those situated in the eastern mountainous area of the region. In conclusion, this study produced a MS prevalence estimate at regional level using population-based health administrative databases. Our results showed the Lazio region is a high-risk area for MS, although with an uneven geographical distribution. While some limitations must be considered including possible prevalence underestimation, HIS represent a valuable source of information to measure the burden of SM, useful for epidemiological surveillance and healthcare planning.
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Bargagli
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Colais
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy. n.agabiti@deplazio.it.
authors.forename: Nera
authors.initials: N
authors.lastname: Agabiti
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Mayer
authors.affiliation: MS Clinical and Research Center, Tor Vergata University and Hospital, Via Montpellier 1, 00133, Rome, Italy.|IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Via Atinense 18, 86077, Pozzilli, Isernia, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Buttari
authors.affiliation: MS Clinical and Research Center, Tor Vergata University and Hospital, Via Montpellier 1, 00133, Rome, Italy.|IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Via Atinense 18, 86077, Pozzilli, Isernia, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Centonze
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Di Folco
authors.affiliation: Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Besta, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Filippini
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy.
authors.forename: Ada
authors.initials: A
authors.lastname: Francia
authors.affiliation: Department of Neurosciences, S Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, 00152, Rome, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Galgani
authors.affiliation: Department of Neurosciences, S Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, 00152, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Gasperini
authors.affiliation: Multiple Sclerosis Center, S Andrea Hospital, Sapienza University, Via di Grottarossa 1037, 00189, Rome, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Giuliani
authors.affiliation: Multiple Sclerosis Center, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Largo Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mirabella
authors.affiliation: Multiple Sclerosis Center, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Largo Agostino Gemelli 8, 00168, Rome, Italy.|Institute of Neurorehabilitation, Don C Gnocchi Foundation, Via Pier Alessandro Paravia 71, 20148, Milan, Italy.
authors.forename: Viviana
authors.initials: V
authors.lastname: Nociti
authors.affiliation: Multiple Sclerosis Center, S Andrea Hospital, Sapienza University, Via di Grottarossa 1037, 00189, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Pozzilli
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Davoli
mesh_terms: D000328:Adult; D017677:Age Distribution; D000465:Algorithms; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D015995:Prevalence; D017678:Sex Distribution
keywords: Epidemiology; Health administrative data; Health information systems; Multiple sclerosis; Prevalence