scholarly journals Lower prevalence of multiple sclerosis in First Nations Canadians

2018 ◽  
Vol 8 (1) ◽  
pp. 33-39
Author(s):  
Ruth Ann Marrie ◽  
Stella Leung ◽  
Nancy Yu ◽  
Lawrence Elliott
Keyword(s):  
Multiple Sclerosis ◽  
First Nations ◽  
Incidence Rate ◽  
Negative Binomial ◽  
Population Based ◽  
Health Claims ◽  
Indigenous Populations ◽  
Health Claims Data ◽  
Manitoba Health ◽  
Crude Prevalence

BackgroundWe compared the incidence and prevalence of multiple sclerosis (MS) between First Nations (FN) and non-FN populations in Manitoba.MethodsWe 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.ResultsFrom 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).ConclusionsThe 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.

scholarly journals Comparative effectiveness of dimethyl fumarate in Multiple Sclerosis

2021 ◽  
Author(s):  
Pauline Bosco-Levy ◽  
Marc Debouverie ◽  
Bruno Brochet ◽  
Céline Louapre ◽  
Elisabeth Maillard ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Negative Binomial ◽  
Real Life ◽  
Logistic Models ◽  
Negative Binomial Regression ◽  
Dimethyl Fumarate ◽  
Population Based ◽  
Disability Progression ◽  
Real Life Setting ◽  
Using Data

Abstract Objectives: To assess the effectiveness of dimethyl fumarate (DMF) on annual rate of relapse (ARR) and disability progression in multiple sclerosis (MS) compared to injectable immunomodulators (IMM), teriflunomide (TERI) and fingolimob (FTY), in real life setting. Methods: A population-based cohort study was conducted using data of the French nationwide claims database, SNDS. All patients initiating IMM, TERI, FTY or DMF between July 1, 2015 and December 12, 2017, with 4.5 years of database history and 1 to 3.5 years of follow-up were included in this study. DMF patients were 1:1 matched to IMM, TERI or FTY using a high dimensional Propensity Score. Negative binomial regression and a regression logistic models were used to estimate the relative risk (RR ± [95% CI]) of ARR and the Odds Ratio (OR ± [95% CI]) of disability progression, respectively. Results: Overall, 9 304 subjects were identified: 29.0% initiated DMF, 33.2% TERI, 5.6% FTY and 32.2% an IMM. The matched cohorts consisted of 1779 DMF- IMM, patients, 1679 DMF-TERI patients, and 376 DMF-FTY patients. DMF significantly reduced ARR compared to IMM (RR 0.72 [0.61 - 0.86]) and TERI (0.81 [0.68 - 0.96]). The risk of the progression of MS specific disability was not significantly different for any matched cohorts.Interpretation: DMF is associated with lower risk of relapse for patients with RRMS than other first-line RRMS agents (TERI and IIM).

Five-year nationwide incidence of macular hole requiring surgery in Korea

2019 ◽  
Vol 103 (11) ◽  
pp. 1619-1623 ◽  
Author(s):  
Soo Chang Cho ◽  
Sang Jun Park ◽  
Seong Jun Byun ◽  
Se Joon Woo ◽  
Kyu Hyung Park
Keyword(s):  
Incidence Rate ◽  
Macular Hole ◽  
Census Data ◽  
Direct Method ◽  
Reference Population ◽  
Population Based ◽  
Health Claims ◽  
Diagnostic Code ◽  
Claims Database ◽  
Male Ratio

Background/aimsTo estimate the incidence and demographics of macular hole (MH) requiring surgery in Korea.MethodsPatients who underwent surgery for MH in Korea from 2011 to 2015 with the diagnostic code for MH and the surgical code for vitrectomy were retrospectively identified using the Korean national health claims database. The average incidence rate of MH during the 5-year study period was estimated by applying the direct method of standardisation using the 2015 census data as a reference population.ResultsA total of 7301 patients with MH requiring surgery were identified. The average incidence of MH requiring surgery was 3.14 (95 % CI, 3.07 to 3.21) per 100 000 person-years . The incidence in women (4.29 per 100 000 person-years; 95% CI, 4.17 to 4.40) was significantly higher than that in men (2.00 per 100 000 person-years; 95% CI, 1.92 to 2.07; p<0.001). The incidence rate of MH increased exponentially with increasing age between the ages of 35 years and 69 years and was highest among patients aged 65–69 years. The female-to-male ratio for the incidence of MH was 2.15:1.ConclusionsThis study represents the largest nationwide population-based investigation of the incidence of MH, using a database that covers the entire population of South Korea. MH is the disease of elderly peaked 70 years old and more common in women.

scholarly journals Incidence and Characteristics of Intraocular Lens Dislocation after Phacoemulsification: An Eight-Year, Nationwide, Population-Based Study

2021 ◽  
Vol 10 (17) ◽  
pp. 3830
Author(s):  
Ga-In Lee ◽  
Dong Hui Lim ◽  
Sang Ah Chi ◽  
Seon Woo Kim ◽  
Jisang Han ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Incidence Rate ◽  
Population Based ◽  
Health Claims ◽  
Cumulative Probability ◽  
Population Based Study ◽  
Young Males ◽  
Intraocular Lens Dislocation ◽  
Cumulative Probabilities ◽  
Iol Dislocation

Background: We investigate the incidence and characteristics of IOL dislocation among the pseudophakic population after phacoemulsification. Methods: National data were collected from the health claims recorded with the Health Insurance Review and Assessment Service of South Korea from 2009 to 2016. Pseudophakic patients aged 40 years or older were included. The incidence estimates of phacoemulsification and IOL dislocation were analyzed, and the cumulative probabilities of IOL dislocation among the pseudophakic population and general population were calculated as a proportion. Results: Of 51,307,821 total subjects, 25,271,917 of whom were aged 40 years or older, 3,906,071 cataract cases in 2,650,104 pseudophakic patients were identified, and 72,309 patients experienced IOL dislocation. The cumulative probability was 2.73% per person and 1.85% per surgery among patients 40 years of age or older. The eight-year incidence rate for IOL dislocation in the pseudophakic population aged 40 years or older was 7671 per 1,000,000 person-years (95% CI: 7616–7727), including 10,341 cases in men and 5814 in women. Incidence peaked in the seventh decade of life for cataract surgery but in the fifth decade of life for IOL dislocation. The cumulative probability of IOL dislocation after phacoemulsification was approximately 2%, and the incidence rate was about 7000 per 1,000,000 pseudophakic patients. Conclusions: There was a significantly higher incidence of IOL dislocation among young males, even though the higher incidence of cataract surgery was observed among older females. These estimates of the nationwide, population-based incidence of IOL dislocation can help increase understanding of the population vulnerable to IOL dislocation.

scholarly journals Incidence and trends of limb amputation in first nations and general population in Saskatchewan, 2006–2019

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254543
Author(s):  
Samuel Kwaku Essien ◽  
Gary Linassi ◽  
Margaret Larocque ◽  
Audrey Zucker-Levin
Keyword(s):  
General Population ◽  
First Nations ◽  
Negative Binomial ◽  
Wrist Joint ◽  
Major Amputation ◽  
Indigenous Populations ◽  
Limb Amputation ◽  
Income Quintile ◽  
Predisposing Factor ◽  
Indian Act

Background There is conflicting evidence whether limb amputation (LA) disproportionately affects indigenous populations. To better understand this disparity, we compared the LA incidence rate between First Nations persons registered under the Indian Act of Canada (RI) and the general population (GP) in Saskatchewan. Methods We used Saskatchewan’s retrospective administrative data containing hospital discharge LA cases, demographic characteristics (age and sex), and residents population reported in the database stratified by RI and GP from 2006–2019. The LA cases for each stratified group were first disaggregated into three broad categories: overall LA (all reported LA), primary LA (first reported LA), and subsequent LA (revision or contralateral LA), with each category further split into the level of amputation defined as major amputation (through/above the ankle/wrist joint) and minor amputation (below the ankle/wrist joint). LA rates were calculated using LA cases as the numerator and resident population as the denominator. Joinpoint and negative binomial regressions were performed to explore the trends further. Results Overall, there were 1347 RI and 4520 GP LA cases reported in Saskatchewan from 2006–2019. Primary LA made up approximately 64.5% (869) of RI and 74.5% (3369) of GP cases, while subsequent LA constituted 35.5% (478) of RI and 25.5% (1151) of GP cases. The average age-adjusted LA rate was 153.9 ± 17.3 per 100,000 in the RI cohort and 31.1 ± 2.3 per 100,000 in the GP cohort. Overall and primary LA rates for the GP Group declined 0.7% and 1.0%, while subsequent LA increased 0.1%. An increased LA rate for all categories (overall 4.9%, primary 5.1%, and subsequent 4.6%) was identified in the RI group. Overall, minor and major LA increased by 6.2% and 3.3%, respectively, in the RI group compared to a 0.8% rise in minor LA and a 6.3% decline in major LA in the GP group. RI females and males were 1.98–1.66 times higher risk of LA than their GP counterparts likewise, RI aged 0–49 years and 50+ years were 2.04–5.33 times higher risk of LA than their GP cohort. Diabetes mellitus (DM) was the most prevalent amputation predisposing factor in both groups with 81.5% of RI and 54.1% of GP diagnosed with DM. Also, the highest proportion of LA was found in the lowest income quintile for both groups (68.7% for RI and 45.3% for GP). Conclusion Saskatchewan’s indigenous individuals, specifically First Nations persons registered under the Indian Act of Canada, experience LA at a higher rate than the general population. This disparity exists for all variables examined, including overall, primary, and subsequent LA rates, level of amputation, sex, and age. Amplification of the disparities will continue if the rates of change maintain their current trajectories. These results underscore the need for a better understanding of underlying causes to develop a targeted intervention in these groups.

Multiple sclerosis in the Iranian immigrant population of BC, Canada: prevalence and risk factors

2014 ◽  
Vol 20 (9) ◽  
pp. 1182-1188 ◽  
Author(s):  
Colleen Guimond ◽  
Joshua D Lee ◽  
Sreeram V Ramagopalan ◽  
David A Dyment ◽  
Heather Hanwell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Population Based ◽  
Personal History ◽  
Canadian Study ◽  
Iranian Immigrants ◽  
High Prevalence ◽  
History Of ◽  
Low Prevalence ◽  
Crude Prevalence

Background: There is a well-documented increase in the risk of multiple sclerosis (MS) when migrating from a region of low prevalence to one of high prevalence. Objective: We present here an investigation of MS prevalence and candidate environmental and genetic risk factors among Iranian immigrants to British Columbia (BC), Canada. Methods: MS cases of Iranian ancestry were ascertained from a population-based Canadian study. We collected blood samples for genetic and serological analyses, and administered a personal history questionnaire to the cases. Results: The crude prevalence of MS in this population of Iranian ancestry was 287/100,000 (95% CI: 229 – 356/100,000). MS cases were more likely to have a history of infectious mononucleosis (odds ratio (OR) = 7.5; p = 0.005) and smoking (OR = 17.0; p < 0.0001), as compared to healthy controls from previous studies in Iran. Cases were also more likely than controls to have been born between April and September (OR = 2.1; p = 0.019). Conclusion: The prevalence of MS among Iranian immigrants to Canada is greater than the overall prevalence of MS in Iran by a factor of at least four, and is similar to that recently observed among Iranian immigrants in other western nations. No major genetic susceptibility variants were identified, suggesting the environment in Canada may be what is increasing the risk of MS in this population.

Pediatric-onset multiple sclerosis and other acquired demyelinating syndromes of the central nervous system in Denmark during 1977–2015: A nationwide population-based incidence study

2017 ◽  
Vol 24 (8) ◽  
pp. 1077-1086 ◽  
Author(s):  
Magnus Spangsberg Boesen ◽  
Melinda Magyari ◽  
Nils Koch-Henriksen ◽  
Lau Caspar Thygesen ◽  
Alfred Peter Born ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Incidence Rate ◽  
Pediatric Population ◽  
Age At Onset ◽  
Population Based ◽  
Incidence Rates ◽  
National Patient ◽  
The Central Nervous System ◽  
Definition Of ◽  
Referral Bias

Background: The incidence of acquired demyelinating syndromes (ADS) including multiple sclerosis (MS) has never been investigated in a Danish pediatric population. Objectives: We estimated the nationwide age- and sex-specific incidence of pediatric ADS including MS. Methods: Data were sourced from the Danish Multiple Sclerosis Registry, providing cases of pediatric MS for 1977–2015, and the National Patient Register, providing cases of ADS during 2008–2015. All medical records were reviewed to validate the register-based diagnoses. Results: We identified 364 cases of pediatric MS occurring during 1977–2015 (incidence rate = 0.79 per 100,000 person-years). MS was exceptionally rare before puberty, but the incidence rose considerably from 9 years in girls and 11 years in boys. The female-to-male ratio was 2.5; the median age at onset was 16 years (range = 7–17 years). The MS incidence rate was relatively stable through the study period. During 2008–2015, we identified 219 ADS cases. The incidence was 2.29 per 100,000 person-years with considerable differences in the age peaks for the separate ADS. Conclusion: The incidence rates of MS and other ADS in Denmark were higher than those reported for some other European countries. Referral bias and classification differences may account for this disparity, in particular the age-intervals and the definition of onset.

scholarly journals Diabetes in pregnancy in associations with perinatal and postneonatal mortality in First Nations and non-Indigenous populations in Quebec, Canada: population-based linked birth cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025084 ◽  
Author(s):  
Lu Chen ◽  
Wen-Juan Wang ◽  
Nathalie Auger ◽  
Lin Xiao ◽  
Jill Torrie ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
First Nations ◽  
Birth Cohort ◽  
Perinatal Death ◽  
Population Based ◽  
Indigenous Populations ◽  
Birth Cohort Study ◽  
Postneonatal Mortality ◽  
Increased Risk

ObjectiveBoth pregestational and gestational diabetes mellitus (PGDM, GDM) occur more frequently in First Nations (North American Indians) pregnant women than their non-Indigenous counterparts in Canada. We assessed whether the impacts of PGDM and GDM on perinatal and postneonatal mortality may differ in First Nations versus non-Indigenous populations.DesignA population-based linked birth cohort study.Setting and participants17 090 First Nations and 217 760 non-Indigenous singleton births in 1996–2010, Quebec, Canada.Main outcome measuresRelative risks (RR) of perinatal and postneonatal death. Perinatal deaths included stillbirths and neonatal (0–27 days of postnatal life) deaths; postneonatal deaths included infant deaths during 28–364 days of life.ResultsPGDM and GDM occurred much more frequently in First Nations (3.9% and 10.7%, respectively) versus non-Indigenous (1.1% and 4.8%, respectively) pregnant women. PGDM was associated with an increased risk of perinatal death to a much greater extent in First Nations (RR=5.08[95% CI 2.99 to 8.62], p<0.001; absolute risk (AR)=21.6 [8.6–34.6] per 1000) than in non-Indigenous populations (RR=1.76[1.17, 2.66], p=0.003; AR=4.2[0.2, 8.1] per 1000). PGDM was associated with an increased risk of postneonatal death in non-Indigenous (RR=3.46[1.71, 6.99], p<0.001; AR=2.4[0.1, 4.8] per 1000) but not First Nations (RR=1.16[0.28, 4.77], p=0.35) infants. Adjusting for maternal and pregnancy characteristics, the associations were similar. GDM was not associated with perinatal or postneonatal death in both groups.ConclusionsThe study is the first to reveal that PGDM may increase the risk of perinatal death to a much greater extent in First Nations versus non-Indigenous populations, but may substantially increase the risk of postneonatal death in non-Indigenous infants only. The underlying causes are unclear and deserve further studies. We speculate that population differences in the quality of glycaemic control in diabetic pregnancies and/or genetic vulnerability to hyperglycaemia’s fetal toxicity may be contributing factors.

scholarly journals P767 Prevalence and incidence rates of inflammatory bowel disease among First Nations: Population-based evidence from Saskatchewan, Canada

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S608-S609
Author(s):  
J N Peña-Sánchez ◽  
D Jennings ◽  
J A Osei ◽  
M Andkhoie ◽  
C Brass ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
General Population ◽  
First Nations ◽  
Negative Binomial ◽  
Population Based ◽  
Incidence Rates ◽  
Annual Prevalence ◽  
Inflammatory Bowel ◽  
Over Time

Abstract Background Worldwide, the epidemiology of inflammatory bowel disease (IBD) has been widely studied in the general population; however, there is limited-to-no evidence about IBD among Indigenous peoples, specifically among First Nations (FNs). Saskatchewan (SK) is a province in western Canada with a population of 1.1 million, 11% of whom are FNs. We aimed to estimate the prevalence, incidence, and trends of IBD among FNs in SK since 1999. Methods As part of a patient-oriented research project, we conducted a retrospective population-based study between 1999 and 2016 fiscal years using administrative data for the province of SK. A previously validated algorithm that required multiple health care contacts was applied to identify IBD cases (Crohn’s disease [CD] and ulcerative colitis [UC]). The ‘self-declared FN status’ variable in the Person Health Registration System was used to determine FNs meeting the IBD case definition and the population at risk. Generalised linear models (GLMs) with generalised estimated equations and a negative binomial distribution were used to estimate the annual prevalence of IBD, CD, and UC. Incidence rates and their corresponding 95% confidence intervals (95%CI) were estimated using GLMs with a negative binomial distribution. The GLMs were used to test trends overtime. Results The annual prevalence of IBD among FNs in SK increased from 64 (95%CI 62–66) per 100,000 people in 1999 to 142 (95%CI 140–144) per 100,000 population in 2016. Also, the prevalence of CD and UC increased during the study period, with 53/100,000 (95%CI 52–55) for CD and 87/100,000 (95%CI 86–89) for UC in 2016. The average increase in the prevalence of IBD was 4.2% (95%CI 3.2–5.2) per year, with similar trends observed in CD (4.1% [95%CI 3.3–4.9]) and UC (3.4% [95%CI 2.3–4.6]). The incidence rates of IBD among FNs were 11 (95%CI 5–25) per 100,000 people in 1999 and 3 (95%CI 1–11) per 100,000 population in 2016. No statistically significant changes were observed in the incidence rates over time (p = 0.09). Conclusion This study is the first epidemiological work providing detailed evidence of IBD among FNs. We identified that FNs have increasing trends in the prevalence of IBD, which has also been described in the Canadian general population. In contrast to the general population of Canada and other developed countries that have shown decreasing trends, the incidence rates of IBD among FNs appear to be stable over time. Also, among FNs, UC appears to be more prevalent than CD; this pattern has been observed in the general populations of developing countries. These results illuminate the need to advocate for better health care and wellness for FNs living with IBD.

Epidemiologie des Diabetes

2017 ◽  
Vol 12 (06) ◽  
pp. 437-446 ◽  
Author(s):  
Esther Jacobs ◽  
Wolfgang Rathmann
Keyword(s):  
Claims Data ◽  
Population Based ◽  
Health Claims ◽  
Undiagnosed Diabetes ◽  
Current Evidence ◽  
Health Claims Data ◽  
Regional Deprivation ◽  
Regional Population ◽  
Methodological Aspects ◽  
Complications And Mortality

AbstractFor Germany, estimates for diabetes prevalence, incidence, morbidity and mortality are based on different study types, e. g. regional population-based studies, surveys or health claims data, and various methods are used for the calculations. Thus, there are a number of different epidemiological estimates published. This is also true for the prevalence of people with undiagnosed diabetes and prediabetes. In addition, evidence exists that the prevalence of diabetes varies between regions in Germany. In this context, new risk factors, such as regional deprivation and air pollution, are currently in the focus. This article gives a short overview on the current research status in diabetes epidemiology with regard to the situation in Germany. Trends in the development of diabetes, its complications and mortality are also discussed. Based on the current refugee situation, the article contains a short insight of available studies on this topic. The overview on the current evidence is supplemented by methodological aspects that should be taken into account when interpreting studies.

scholarly journals Trends in Prevalence and Severity of Pre/Perinatal Cerebral Palsy Among Children Born Preterm From 2004 to 2010: A SCPE Collaboration Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Catherine Arnaud ◽  
Virginie Ehlinger ◽  
Malika Delobel-Ayoub ◽  
Dana Klapouszczak ◽  
Oliver Perra ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Incidence Rate ◽  
Gestational Age ◽  
Rate Ratio ◽  
Negative Binomial ◽  
Incidence Rate Ratio ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Preterm Born

Aim: To report on prevalence of cerebral palsy (CP), severity rates, and types of brain lesions in children born preterm 2004 to 2010 by gestational age groups.Methods: Data from 12 population-based registries of the Surveillance of Cerebral Palsy in Europe network were used. Children with CP were eligible if they were born preterm (&lt;37 weeks of gestational age) between 2004 and 2010, and were at least 4 years at time of registration. Severity was assessed using the impairment index. The findings of postnatal brain imaging were classified according to the predominant pathogenic pattern. Prevalences were estimated per 1,000 live births with exact 95% confidence intervals within each stratum of gestational age: ≤27, 28–31, 32–36 weeks. Time trends of both overall prevalence and prevalence of severe CP were investigated using multilevel negative binomial regression models.Results: The sample comprised 2,273 children. 25.8% were born from multiple pregnancies. About 2-thirds had a bilateral spastic CP. 43.5% of children born ≤27 weeks had a high impairment index compared to 37.0 and 38.5% in the two other groups. Overall prevalence significantly decreased (incidence rate ratio per year: 0.96 [0.92–1.00[) in children born 32–36 weeks. We showed a decrease until 2009 for children born 28–31 weeks but an increase in 2010 again, and a steady prevalence (incidence rate ratio per year = 0.97 [0.92–1.02] for those born ≤27 weeks. The prevalence of the most severely affected children with CP revealed a similar but not significant trend to the overall prevalence in the corresponding GA groups. Predominant white matter injuries were more frequent in children born &lt;32 weeks: 81.5% (≤27 weeks) and 86.4% (28–31 weeks), compared to 63.6% for children born 32–36 weeks.Conclusion: Prevalence of CP in preterm born children continues to decrease in Europe excepting the extremely immature children, with the most severely affected children showing a similar trend.

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