Geographic and Temporal Distribution of Mortality Rates for Multiple Sclerosis in Canada, 1965–1994

Warren, Sharon; Warren, Kenneth G.; Svenson, Larry; Schopflocher, Donald; Jones, Allyson

doi:10.1159/000067111

Cited by 12 publications

(10 citation statements)

References 29 publications

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“…This contrasts with a recent study of US national mortality data which found increased mortality between 1990 and 2001 [23]. In other countries, such as Canada, rates have been reported to fluctuate over time rather than show a directional trend [29]. We found no evidence of either a rise or decline in the Oxford region overall, from 1979 to 2006.…”

Section: Multiple Sclerosiscontrasting

confidence: 99%

Trends in death certification for multiple sclerosis, motor neuron disease, Parkinson’s disease and epilepsy in English populations 1979–2006

et al. 2009

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The objective of this study is to report trends in mortality, as certified on death certificates, from multiple sclerosis (MS), motor neuron disease (MND), primary Parkinson's disease (PD), and epilepsy, analysing not only the underlying cause of death but also all certified causes for each disease. Death records in the Oxford region, 1979-2006, and England, 1996-2006, were analysed for ascertaining the trends in mortality. The percentage of deaths coded as the underlying cause changed over time, coinciding with changes to the rules for selecting the underlying cause of death. Changes over time to coding rules had a large impact on apparent trends in death rates for PD when studied by underlying cause alone. They also had significant, though smaller, effects on trends in death rates for MS, MND and epilepsy. Nationally, in the last period of the study, underlying cause mortality identified 64% of deaths with a mention of MS, 88% of MND, 56% of PD, and 48% of epilepsy. In the longstanding Oxford data from 1979 to 2006, death rates based on all certified causes of death showed no significant change for MS; an upward trend for MND (notably in women over 75), though only in the last few years of the study; a significant but small decline for PD; and no significant change for epilepsy. When mortality statistics are analysed by underlying cause only, their value is reduced. A substantial percentage of neurological deaths are missed. Time trends may be misleading. All certified causes for each disease, as well as the underlying cause, should be analysed.

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Section: Multiple Sclerosiscontrasting

confidence: 99%

Trends in death certification for multiple sclerosis, motor neuron disease, Parkinson’s disease and epilepsy in English populations 1979–2006

et al. 2009

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“…Moreover, some papers have identified a lack of correlation between prevalence and mortality distribution [13], probably due to differences in health care or disease severity [14].…”

Section: Discussionmentioning

confidence: 99%

Mortality of Multiple Sclerosis in Spain: Demonstration of a North-South Gradient

Llorca¹,

Guerrero²,

Prieto-Salceda³

et al. 2005

Neuroepidemiology

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Objective: To analyse the geographical distribution of multiple sclerosis in Spain from 1975 to 1998. Methods: Age-adjusted mortality rates by province were obtained by the indirect method using the whole Spanish population as the reference. Then, standardised mortality ratios (SMRs) and their 95% confidence intervals were estimated. Results: For both men and women, provinces with SMRs higher than the mean tended to be in the northern third of Spain, whilst those with SMRs lower than the mean were mostly located in the southern half. A linear regression analysis showed a significant positive association between mortality and latitude. Conclusion: A north-south gradient in age-adjusted multiple sclerosis mortality exists in Spain.

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“…Like other presumed autoimmune diseases, MS is more common in females and clinical symptoms often appear during young adulthood [21]. Patients with MS show relatively high morbidity and mortality rates, especially in chronic progressive forms of the disease and particularly among those living in high latitudes [22,23], both in the northern and southern hemispheres.…”

Section: Discussionmentioning

confidence: 99%

Multiple Sclerosis, Sporadic Creutzfeldt–Jakob Disease and Bovine Spongiform Encephalopathy: Are they Autoimmune Diseases Evoked byAcinetobacterMicrobes Showing Molecular Mimicry to Brain Antigens?

Ebringer

Rashid

Wilson

et al. 2004

Journal of Nutritional & Environmental Medicine

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Purpose and Design: Microbial agents showing molecular mimicry to self-antigens have been reported to initiate an autoimmune pathology in several diseases, including Sydenham's chorea, rheumatic fever, rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Cows affected by bovine spongiform encephalopathy (BSE) have been shown to have antibodies to Acinetobacter species, microbes that are known to possess bacterial antigens showing molecular mimicry with brain antigens. In this study, the possibility that patients with multiple sclerosis (MS) and sporadic Creutzfeldt-Jakob disease (sCJD) have elevated antibodies to bacterial and brain antigens was investigated. Materials and Methods: Serum samples from different groups of patients, including 53 with MS, 20 with RA, 20 with AS, two with sCJD, 18 with cerebrovascular accident (CVA) and 20 with viral encephalitis, as well as 29 healthy control subjects were tested using the enzymelinked immunosorbent assay (ELISA) method for the determination of antibodies against Acinetobacter, Klebsiella, Proteus and Escherichia microbes, as well as myelin basic protein (MBP) brain antigens. Results: Significantly elevated levels of IgA and IgG antibodies to Acinetobacter and MBP were observed in sera of MS and sCJD patients when compared with patients with encephalitis, CVA, AS, RA as well as 29 healthy blood donors. Furthermore, MS patients had shown a significant correlation between anti-Acinetobacter and anti-MBP antibody levels. Anti-Klebsiella antibodies were found to be elevated only in AS patients and anti-Proteus antibodies elevated only in RA patients. Conclusions: MS and possibly sCJD could develop as the result of an autoimmune response to Acinetobacter bacteria. The possible role of this microbe in evoking autoimmune responses in MS or sCJD requires further evaluation.

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Geographic and Temporal Distribution of Mortality Rates for Multiple Sclerosis in Canada, 1965–1994

Cited by 12 publications

References 29 publications

Trends in death certification for multiple sclerosis, motor neuron disease, Parkinson’s disease and epilepsy in English populations 1979–2006

Trends in death certification for multiple sclerosis, motor neuron disease, Parkinson’s disease and epilepsy in English populations 1979–2006

Mortality of Multiple Sclerosis in Spain: Demonstration of a North-South Gradient

Multiple Sclerosis, Sporadic Creutzfeldt–Jakob Disease and Bovine Spongiform Encephalopathy: Are they Autoimmune Diseases Evoked byAcinetobacterMicrobes Showing Molecular Mimicry to Brain Antigens?

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