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Multiple Sclerosis in Newfoundland and Labrador - A Model for Disease Prevalence

  • J.S. Sloka (a1), W.E.M. Pryse-Phillips (a2) and M. Stefanelli (a2)

Abstract

Background:

Newfoundland and Labrador, Canada, have been almost exclusively populated by immigrants from southwest England and southeast Ireland. The province’s population grew largely by natural increase from 20,000 people in 1835 to half a million at present. Very little interregional migration occurred within the province. This uniquely-populated region and its subsequent founder effect provide the basis to develop models of disease prevalence.

Objectives:

To develop a model for the regional prevalence of multiple sclerosis (MS), accounting for settlement patterns and geographic location (latitude).

Methods:

All living MS patients with confirmed addresses (438 patients) in the province were mailed a survey requesting their place of birth. Regional prevalences were calculated from a 75% rate of return of the survey. Theoretical regional prevalences were proportionally calculated from the source prevalences of southwest England, southeast Ireland, Scotland and the Channel Islands based on settlement patterns. These theoretical regional prevalences were corrected for geographical variations of latitude based on observations in the United Kingdom. Theoretical and actual regional prevalences were compared.

Results:

When actual regional prevalences were compared with theoretical prevalences, very little variation was noted, especially after correcting for variation in latitude.

Conclusion:

A regional variation in MS prevalence is noted in the island portion of Newfoundland and Labrador. This regional variation can be modeled by using both migration patterns and latitudinal position. This model demonstrates that the prevalence of MS is influenced by both genetic and environmental contributions.

RÉSUMÉ:

Terre–Neuve et le Labrador au Canada, ont été peuplés presque exclusivement par des immigrants du sud–ouest de l’Angleterre et du sud–est de l’Irlande. La population de la province s’est accrue principalement par la croissance naturelle, de 20,000 habitants en 1835 à un demi–million actuellement, avec peu de migrations interrégionales à l’intérieur de la province. Cette région qui a des caractéristiques de peuplement particulières et un effet fondateur, sert de base à l’élaboration de modèles de prévalence de la maladie

Objectifs:

Développer un modèle de la prévalence régionale de la sclérose en plaques (SEP) en tenant compte du mode de peuplement et de la localization géographique (latitude).

Méthodes:

On a procédé à une enquête postale auprès de tous les patients vivants atteints de SEP et ayant une adresse de résidence confirmée dans la province (438 patients) leur demandant leur lieu de naissance. Le taux de réponse a été de 75%. Le calcul des prévalences régionales est basé sur cette enquête. Des prévalences régionales théoriques ont été calculées proportionnellement aux taux de prévalence des régions sources, soit le sud–ouest de l’Angleterre, le sud–est de l’Irlande, l’Écosse et les Iles Anglo–Normandes, selon le mode de peuplement. Ces prévalences régionales théoriques ont été corrigées pour les variations géographiques de latitude basées sur les observations au Royaume–Uni. Les prévalences régionales théoriques et réelles ont été comparées.

Conclusion:

Nous avons observé une variation régionale dans la prévalence de la SEP dans la portion insulaire de Terre–Neuve et du Labrador. Cette variation régionale peut être modélisée en utilisant le profil migratoire et la latitude. Ce modèle démontre que la génétique et l’environnement influencent la prévalence de la SEP.

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