Rev Neurol 2001 Nov 16;33(10):931-937
Martinez Sobrepera HJ, Cabrera Gomez
JA, Tuero Iglesias A.
Servicio de Neurologia; Instituto
Nacional de Neurologia y Neurocirugia, La Habana, 10400, Cuba.
INTRODUCTION.
Descriptive epidemiological studies
indicate that the prevalence of multiple sclerosis (MS) in Cuba is in the
mid range of risk. It is not known what exogenous factors may be related
to the aetiology of MS.
OBJECTIVE.
To study the exogenous factors possibly
related to the aetiology of MS in the central provinces of Cuba.
PATIENTS AND METHODS.
We studied all the patients with
definite clinical MS (Poser et al) with positive MR who came from the provinces
of Cienfuegos, Villa Clara and Sancti Spiritus. The protocol was approved
by the Medical Ethics Committees of each of the three institutions and
reviewed by two international authorities on the subject. Each of the patients
(cases) and one member of their family (control), after written consent,
when they fulfilled the criteria for inclusion in the study, were personally
interviewed by trained persons and the questionnaire for studying cases
and controls of Boiko et al was completed. The questionnaire had been adapted
for use in Cuba. The main data obtained were: demographic data, history
of occupation and residence, personal medical history, exposure to possibly
toxic substances, diet and nutrition, contact with animals and life style.
For measurement of risk we used the risk of the results of the crossed
products odds ratio (OR) with its confidence interval (CI), always insisting
on precision of 95%.
RESULTS.
High educational level (OR=?2.293;
95% CI=?0.9 5.4), two or more children (OR=?2.84; 95% CI=?1.22 6.59), four
or more pregnancies (OR=?3.60; 95% CI=?0.69 18.7), three or more deliveries
(OR=?1.939, 95% CI=?0.44 8.4); previous measles infection (OR=?2.042; 95%
CI=?0.76 5.47), a history of migraine (OR=?2.538; 95% CI=?0.81 7.94); stress
(OR=?3.768; 95% CI=?1.64 8.62) and insomnia (OR=?2.95; 95% CI=?1.14 7.14)
were the factors related to MS.
CONCLUSIONS.
This study confirmed the existence
of exogenous factors in the aetiology of patients with clinically defined
MS and positive MR findings who lived in the provinces studied in Cuba.
The exogenous factors found in this population of patients with MS were:
high educational level, two or more children, four or more pregnancies,
three or more deliveries, previous measles, a history of migraine, stress
and insomnia.