Epidemiology of multiple sclerosis in Arabs in Kuwait: A comparative study between Kuwaitis and Palestinians

Harvard University, Cambridge, Massachusetts, United States
Journal of the Neurological Sciences (Impact Factor: 2.47). 01/1991; 100(1-2):137-41. DOI: 10.1016/0022-510X(90)90024-H
Source: PubMed


On December 31, 1988 there were 201 registered multiple sclerosis patients in Kuwait, an overall prevalence rate (PR) of 10.2 per 100,000; among them were 186 Arabs, of whom 72 were Palestinians and 51 Kuwaitis. Comparison of these two subgroups, who had a similar age distribution revealed that the disease was 2 1/2 times more frequent among Palestinians (PR 23.8/100,000) than among Kuwaitis (PR 9.5/100,000). Palestinians also showed significant differences from Kuwaitis in eye color, blood group distribution and HLA-DR and HLA-DQW epitopes frequency. This suggests that genetic rather than environmental factors might be the underlying cause for the high susceptibility to develop MS among Arabs originating from the Eastern Mediterranean basin.

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    • "Due to inter- and intra-individual variability, the models of disease occurrence, its’ power, circumstances, and outcome are complicated and unpredictable. The prevalence is distinguished by major discrepancy, which is mediated by hereditary, environmental, and demographic factors.[1–9] In Isfahan/Iran, an increase in prevalence and incidence figures (73.3; 9.1:2004-2005 vs. 43.8; "
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    ABSTRACT: In adults, throughout life, uniqueness maintains the equivalent; but, it might be tailored in the track of neurological disarrays. As in the partition of cognitive function associated with multiple sclerosis (MS), numerous studies have been performed, but there are very few reports in this area of behavior. The aim of this study was to investigate the prevalence of personality types A and B in relation to individuals' behaviors with MS and type A behavior with demographic characteristics and the level of disability. A cross-sectional descriptive study was performed between September 2010 and March 2011 on 50 patients who were referred to MS clinic (located at the Kashani hospital), Isfahan Neurosciences Research Centre (INRC). The subjects were evaluated using Friedman and Rosenman questioner and the Expanded Disability Status Scale (EDSS). The data were analyzed by SPSS software (version 17) based on Chi-square test and independent T-test. Of the subjects, 65% were of personality type A and 35% were of personality type B (X2: 3.5, P < 0.05). There were no significant differences in individuals with type A behavior in relation to gender and marital status. In connection to EDSS (EDSS < 4.5 or EDSS > 4.5), patients with higher EDSS score, i.e., individuals with EDSS > 4.5 mostly had type A behavior pattern. People with type A behavior pattern are reported to have more stress, nervousness, and anxiety. In this study, MS patients had more characteristics of type A than type B behavior. This behavior was increased in individuals with EDSS score > 4.5.
    International journal of preventive medicine 05/2013; 4(Suppl 2):S279-83.
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    • "Our review of the literature showed that all the reports on caregiver QOL in MS have emanated from the temperate/mediterranean countries of Europe and North America, where the disease is traditionally thought to have a higher prevalence and severity[7], compared with countries in the relatively lower latitudes, such as the Arab world[8,9]. "
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    ABSTRACT: Background Research interest in the quality of life (QOL) of persons with multiple sclerosis (MS) has been spurred by the need to broaden outcome measures. Far less of this interest has been directed at the family caregivers, who bear most of the burden of care. The objectives of the study were: First, to compare the subjective QOL of family caregivers of persons with relapsing remitting and progressive MS, with those of a matched general population sample and caregivers of diabetes and psychiatric patients. Second, to assess the relationship of QOL with caregiver attitudes to MS and patient's variables. Methods Consecutive MS clinic attendees were assessed with the 26 – item WHOQOL Instrument, and for depression and disability. Similarly, caregivers independently rated their own QOL as well as their impression of patients' QOL and attitudes to patients' illness. Results The 170 caregivers, mean age 35.7 years, had no significant diagnostic differences in QOL domain scores and attitudes to MS. Caregivers had significantly lower QOL than the general population control group for five out of six domains and the general facet (P < 0.01), but higher QOL than the patients. When the scores were corrected for patients' depression and disability, caregivers had similar QOL with the general population group for four domains. Using corrected scores, MS caregivers had lower scores than diabetic and psychiatric caregivers in the physical, psychological and social relations domains. Majority expressed negative attitudes to MS. Caregiver QOL was more affected by their fear of having MS than their feelings about the illness and caregiving role. Caregiver attitudes had mostly no significant impact on their proxy ratings of patients' QOL. The significant predictor of caregivers' overall QOL was their impression of patients' QOL. Conclusion Caregivers need specific attention if they are less educated, unemployed, afraid of having MS and caring for patients with longer duration of illness and less education. In particular, attention to patients' depression and disability could improve caregivers' QOL. Caregivers need specific programs to address fear of having MS, negative attitudes to illness and their unmet needs.
    BMC Health Services Research 10/2008; 8(1). DOI:10.1186/1472-6963-8-206 · 1.71 Impact Factor
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    • "A review of the literature showed that, with the exception of the report from Iran [6], all the reports on QOL in MS have emanated from the temperate/Mediterranean cultures of Europe and North America, where the disease is traditionally thought to have a higher prevalence and severity[25], compared with countries in the lower latitudes, such as the Arab world[26,27]. Kuwait, a city-state in the Persian Gulf, is one of the relatively low latitude countries where a rising incidence and prevalence of MS has recently been reported[26]. For example, while the prevalence and incidence of MS in Europe are estimated to be 83 per 100,000 and 4.3 cases per 100,000, respectively[25], the figures for the total population in Kuwait are 14.77 per 1000,000 and 2.62 cases per 100,000, respectively[26] (increased from pre-1993 levels of 6.68 and 1.05, respectively, for prevalence and incidence). "
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    ABSTRACT: Assessment of subjective quality of life (QOL) of persons with multiple sclerosis (MS) could facilitate the detection of psychosocial aspects of disease that may otherwise go unrecognized. The objectives of the study were to (i) compare the QOL ratings of relapsing remitting (RRMS) and progressive (PMS) types of MS with those of a general population group and the impression of their family caregivers; and (ii) assess the association of demographic, clinical, treatment, depression, and caregiver variables with patients' QOL. Consecutive clinic attendees at the national neurology hospital were assessed with the 26 -item WHOQOL Instrument, Beck's Depression Inventory and Expanded Disability Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. The 170 patients (60 m, 109 f) consisted of 145(85.3%) with RRMS and 25 with PMS, aged 32.4(SD 8.8), age at onset 27.1(7.7), EDSS score 2.9 (1.8), and 76% were employed. The patients were predominantly dissatisfied with their life circumstances. The RRMS group had higher QOL domain scores (P < 0.001), and lower depression(P > 0.05) and disability (P < 0.0001) scores than the PMS group. Patients had significantly lower QOL scores than the control group (P < 0.001). Caregiver impression was significantly correlated with patients' ratings. Depression was the commonest significant covariate of QOL domains. When we controlled for depression and disability scores, differences between the two MS groups became significant for only one (out of 6) QOL domains. Patients who were younger, better educated, employed, felt less sick and with lesser side effects, had higher QOL. The predictors of patients' overall QOL were disability score, caregiver impression of patients' QOL, and caregiver fear of having MS. Our data indicate that MS patients in stable condition and with social support can hope to have better QOL, if clinicians pay attention to depression, disability, the impact of side effects of treatment and family caregiver anxieties about the illness. The findings call for a regular program of psychosocial intervention in the clinical setting, to address these issues and provide caregiver education and supports, in order to enhance the quality of care.
    BMC Neurology 09/2007; 7(1):31. DOI:10.1186/1471-2377-7-31 · 2.04 Impact Factor
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