Multiple sclerosis in Central America and Caribbean countries: frequency and clinical characterization of an emergent disease.

Autor:	Gracia F; Neurology Service, Hospital Santo Tomás, Panamá, Panama.; Dean of Health Science Faculty, Universidad Interamericana de Panamá, Panamá, Panama., Ramírez Navarro DA; Neurology Service, Hospital Docente Padre Billini, Santo Domingo, Dominican Republic., Ramírez Sánchez NE; Neurology Service, Hospital Público Dr. Mario C. Rivas, San Pedro Sula, Honduras., Weiser R; Neurology Service, Hospital Horacio Oduber, Oranjestad, Aruba., Parajeles-Vindas A; Neurology Service, Hospital San Juan de Dios, Caja Costarricense de Seguro Social (CCSS), San Jose, Costa Rica., Portillo Rivera LI; Neurology Service, Hospital General de Enfermedades, Instituto Guatemalteco de Seguridad Social, Guatemala, Guatemala., Torres EL; Neurology Service, Hospital Nacional Rosales, San Salvador, El Salvador., García Valle LA; Neurology Service, Hospital Militar Escuela Dr. Alejandro Dávila Bolaños, Managua, Nicaragua., Sanabria-Castro A; Neurology Service, Hospital San Juan de Dios, Caja Costarricense de Seguro Social (CCSS), San Jose, Costa Rica., Abdón López C; Neurology Service, Hospital Nacional Rosales, San Salvador, El Salvador., Araujo P; Neurology Service, Complejo Hospitalario Dr. Arnulfo Arias Madrid, Panama, Panama., Ayerdis Zamora MJ; Neurology Service, Hospital Bautista de Nicaragua, Managua, Nicaragua., Balmaceda-Meza A; Neurology Service, Hospital San Juan de Dios, Caja Costarricense de Seguro Social (CCSS), San Jose, Costa Rica., Benzadon Cohen A; Neurology Service, Complejo Hospitalario Dr. Arnulfo Arias Madrid, Panama, Panama., Candelario Cueto A; Neurology Service, Hospital Docente Padre Billini, Santo Domingo, Dominican Republic., Castillo D; Neurology Service, Hospital Nacional Rosales, San Salvador, El Salvador., Castro-Escobar R; Neurology Service, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador., Corea Urbina KZ; Neurology Service, Hospital Militar Escuela Dr. Alejandro Dávila Bolaños, Managua, Nicaragua., de Peña Rivas A; Neurology Service, Centro de Diagnóstico, Medicina Avanzada Conferencias Médicas, Telemedicina (CEDIMAT), Santo Domingo, Dominican Republic., Sotelo OD; Neurology Service, Hospital Militar Escuela Dr. Alejandro Dávila Bolaños, Managua, Nicaragua., Enamorado Claros T; Neurology Service, Instituto Hondureño de Seguro Social, Tegucigalpa, Honduras., Giroud Benítez JL; Neurology Service, Hospital Salud Integral, Managua, Nicaragua., Gracia K; Dean of Health Science Faculty, Universidad Interamericana de Panamá, Panamá, Panama., Larreategui M; Neurology Service, Hospital Regional Anita Moreno, Villa de Los Santos, Panama., Martínez Cerrato JA; Neurology Service, Hospital Vivian Pellas, Managua, Nicaragua., Medina Báez JP; Neurology Service, Hospital Docente Padre Billini, Santo Domingo, Dominican Republic., Menjivar Samayoa CE; Neurology Service, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador., Miranda-Loria G; Neurology Service, Hospital San Rafael de Alajuela, Caja Costarricense de Seguro Social (CCSS), Alajuela, Costa Rica., Monterrey-Alvarez P; Neurology Service, Hospital San Rafael de Alajuela, Caja Costarricense de Seguro Social (CCSS), Alajuela, Costa Rica., Morales Arguello LA; Neurology Service, Hospital Militar Escuela Dr. Alejandro Dávila Bolaños, Managua, Nicaragua., Ortiz M; Neurology Service, Hospital Santo Tomás, Panamá, Panama., Pérez Baldioceda CD; Neurology Service, Hospital Militar Escuela Dr. Alejandro Dávila Bolaños, Managua, Nicaragua., Pinilla Aguilar L; Neurology Service, Complejo Hospitalario Dr. Arnulfo Arias Madrid, Panama, Panama., Salinas LCR; Neurology Service, Instituto Hondureño de Seguro Social, Tegucigalpa, Honduras., Rodríguez-Moreno V; Neurology Service, Hospital San Carlos, Caja Costarricense de Seguro Social (CCSS), San Carlos, Costa Rica., Rojas-Chaves S; Neurology Service, Hospital San Juan de Dios, Caja Costarricense de Seguro Social (CCSS), San Jose, Costa Rica., Román-Garita N; Neurology Service, Hospital San Juan de Dios, Caja Costarricense de Seguro Social (CCSS), San Jose, Costa Rica., Santos Pujols B; Neurology Service, Hospital Regional Universitario Jose Maria Cabral y Baez, Santiago De Los Caballeros, Dominican Republic., Valderrama C; Neurology Service, Hospital Regional Rafael Hernández, David, Panama., Van Sijtveld I; Neurology Service, Hospital Horacio Oduber, Oranjestad, Aruba., Zabala Angeles I; Neurology Service, Centro de Diagnóstico, Medicina Avanzada Conferencias Médicas, Telemedicina (CEDIMAT), Santo Domingo, Dominican Republic., Rivera VM; Neurology Service, Baylor College of Medicine, Houston, TX, United States., Armien B; Directorate of Research and Technological Development, Gorgas Memorial Institute of Health Studies, Panamá, Panama.; Sistema Nacional de Investigación, Secretaria Nacional de Ciencia y Tecnología, Panamá, Panama.
Jazyk:	angličtina
Zdroj:	Frontiers in epidemiology [Front Epidemiol] 2024 Jun 17; Vol. 4, pp. 1368675. Date of Electronic Publication: 2024 Jun 17 (Print Publication: 2024).
DOI:	10.3389/fepid.2024.1368675
Abstrakt:	Background: Multiple Sclerosis (MS) is a common neurological disease among white populations of European origin. Frequencies among Latin Americans continue to be studied, however, epidemiologic, and clinical characterization studies lack from Central American and Caribbean countries. Ethnicity in these countries is uniformly similar with a prevalent Mestizo population. Methods and Results: Data from January 2014 to December 2019 from Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, Panama, Dominican Republic, and Aruba on demographic, clinical, MRI and phenotypic traits were determined in coordinated studies: ENHANCE, a population-based, retrospective, observational study on incidence and clinical characteristics, and from the subgroup with MS national registries (Aruba, Dominican Republic, Honduras, and Panama), data on prevalence, phenotypes and demographics. Expanded Disability Status Scale (EDSS), and therapeutic schemes were included. ENHANCE data from 758 patients disclosed 79.8% of Mestizo ethnicity; 72.4% female; median age at onset 31.0 years and 33.2 at diagnosis. The highest incidence rate was from Aruba, 2.3-3.5 × 100,000 inhabitants, and the lowest, 0.07-0.15 × 100,000, from Honduras. Crude prevalence rates per 100,000 inhabitants fluctuated from 27.3 (Aruba) to 1.0 (Honduras). Relapsing MS accounted for 87.4% of cases; EDSS <3.0 determined in 66.6% (mean disease duration: 9.1 years, SD ± 5.0); CSF oligoclonal bands 85.7%, and 87% of subjects hydroxyvitamin D deficient. Common initial therapies were interferon and fingolimod. Switching from interferon to fingolimod was the most common escalation step. The COVID-19 pandemic affected follow-up aspects of these studies. Conclusion: This is the first study providing data on frequencies and clinical characteristics from 8 countries from the Central American and Caribbean region, addressing MS as an emergent epidemiologic disorder. More studies from these areas are encouraged. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Gracia, Ramírez Navarro, Ramírez Sánchez, Weiser, Parajeles-Vindas, Portillo Rivera, Torres, García Valle, Sanabria-Castro, Abdón López, Araujo, Ayerdis Zamora, Balmaceda-Meza, Benzadon Cohen, Candelario Cueto, Castillo, Castro-Escobar, Corea Urbina, de Peña Rivas, Sotelo, Enamorado Claros, Giroud Benítez, Gracia, Larreategui, Martínez Cerrato, Medina Báez, Menjivar Samayoa, Miranda-Loria, Monterrey-Alvarez, Morales Arguello, Ortiz, Pérez Baldioceda, Pinilla Aguilar, Salinas, Rodríguez-Moreno, Rojas-Chaves, Román-Garita, Santos Pujols, Valderrama, Van Sijtveld, Zabala Angeles, Rivera and Armien.)
Databáze:	MEDLINE
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