Ruth Ann Marrie1, Stella Leung1, Nancy Yu1, Lawrence Elliott1. 1. Departments of Internal Medicine (RAM), Community Health Sciences (RAM, SL, NY, LE), and Medical Microbiology (LE), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Abstract
BACKGROUND: We compared the incidence and prevalence of multiple sclerosis (MS) between First Nations (FN) and non-FN populations in Manitoba. METHODS: We applied previously validated algorithms to population-based administrative (health claims) data from Manitoba, Canada, to identify all persons with MS from 1984 to 2011. We identified FN individuals using the Municipality of Registration field held at Manitoba Health. We compared the incidence and prevalence of MS between the FN and non-FN populations using negative binomial models. RESULTS: From 1984 to 2011, 5,738 persons had MS, of whom 64 (1.1%) were of FN ethnicity. The average annual incidence rate per 100,000 population was 8.15 (95% confidence interval [CI] 5.98-11.1) in the FN population and 15.7 (95% CI 15.1-16.3) in the non-FN population (incidence rate ratio 0.52; 95% CI 0.38-0.71). In 1984, the crude prevalence of MS per 100,000 population was 35.8 (95% CI 14.9-86.1) in the FN population and 113.3 (95% CI 106.3-120.8) in the non-FN population. Between 1984 and 2011, the age-standardized prevalence of MS increased by 351% to 188.5 (95% CI 146.6-230.4) in the FN population. In contrast, the prevalence of MS per 100,000 general population increased by 225%-418.4% (95% CI 405.8-431.0). CONCLUSIONS: The incidence and prevalence of MS are twofold lower in the FN population than the non-FN population. Nonetheless, the prevalence of MS in FN Manitobans is higher than in other indigenous populations outside Canada. Given reports of more rapid disability progression among FN Canadians with MS, and the rising prevalence of MS in this population, attention should be directed to the needs of this population.
BACKGROUND: We compared the incidence and prevalence of multiple sclerosis (MS) between First Nations (FN) and non-FN populations in Manitoba. METHODS: We applied previously validated algorithms to population-based administrative (health claims) data from Manitoba, Canada, to identify all persons with MS from 1984 to 2011. We identified FN individuals using the Municipality of Registration field held at Manitoba Health. We compared the incidence and prevalence of MS between the FN and non-FN populations using negative binomial models. RESULTS: From 1984 to 2011, 5,738 persons had MS, of whom 64 (1.1%) were of FN ethnicity. The average annual incidence rate per 100,000 population was 8.15 (95% confidence interval [CI] 5.98-11.1) in the FN population and 15.7 (95% CI 15.1-16.3) in the non-FN population (incidence rate ratio 0.52; 95% CI 0.38-0.71). In 1984, the crude prevalence of MS per 100,000 population was 35.8 (95% CI 14.9-86.1) in the FN population and 113.3 (95% CI 106.3-120.8) in the non-FN population. Between 1984 and 2011, the age-standardized prevalence of MS increased by 351% to 188.5 (95% CI 146.6-230.4) in the FN population. In contrast, the prevalence of MS per 100,000 general population increased by 225%-418.4% (95% CI 405.8-431.0). CONCLUSIONS: The incidence and prevalence of MS are twofold lower in the FN population than the non-FN population. Nonetheless, the prevalence of MS in FN Manitobans is higher than in other indigenous populations outside Canada. Given reports of more rapid disability progression among FN Canadians with MS, and the rising prevalence of MS in this population, attention should be directed to the needs of this population.
Authors: Ruth Ann Marrie; Bo N Yu; Stella Leung; Lawrence Elliott; Patricia Caetano; Sharon Warren; Christina Wolfson; Scott B Patten; Lawrence W Svenson; Helen Tremlett; John Fisk; James F Blanchard Journal: Mult Scler Relat Disord Date: 2013-04-02 Impact factor: 4.339
Authors: Ruth Ann Marrie; Bo Nancy Yu; Stella Leung; Lawrence Elliott; Patricia Caetano; Sharon Warren; Christina Wolfson; Scott B Patten; Lawrence W Svenson; Helen Tremlett; John Fisk; James F Blanchard Journal: Neuroepidemiology Date: 2012-10-24 Impact factor: 3.282
Authors: Lawrence W Svenson; Sharon Warren; Kenneth G Warren; Luanne M Metz; Scott B Patten; Donald P Schopflocher Journal: Can J Neurol Sci Date: 2007-05 Impact factor: 2.104
Authors: Elaine Kingwell; James J Marriott; Nathalie Jetté; Tamara Pringsheim; Naila Makhani; Sarah A Morrow; John D Fisk; Charity Evans; Sarah Gabrielle Béland; Sophie Kulaga; Jonathan Dykeman; Christina Wolfson; Marcus W Koch; Ruth Ann Marrie Journal: BMC Neurol Date: 2013-09-26 Impact factor: 2.474
Authors: Elaine Kingwell; Feng Zhu; Ruth Ann Marrie; John D Fisk; Christina Wolfson; Sharon Warren; Joanne Profetto-McGrath; Lawrence W Svenson; Nathalie Jette; Virender Bhan; B Nancy Yu; Lawrence Elliott; Helen Tremlett Journal: J Neurol Date: 2015-07-24 Impact factor: 4.849
Authors: Chandima P Karunanayake; William Albritton; Donna C Rennie; Joshua A Lawson; Laura McCallum; P Jenny Gardipy; Jeremy Seeseequasis; Arnold Naytowhow; Louise Hagel; Kathleen McMullin; Vivian Ramsden; Sylvia Abonyi; Jo-Ann Episkenew; James A Dosman; Punam Pahwa; The First Nations Lung Health Project Research Team; The Saskatchewan Rural Health Study Team Journal: Int J Pediatr Date: 2016-02-10