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PLoS One. 2016 Dec 9;11(12):e0167556. doi: 10.1371/journal.pone.0167556. eCollection 2016.

Geographical Heterogeneity of Multiple Sclerosis Prevalence in France.

Author information

1
Clinical and Evaluation department, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
2
EA 4360 Apemac, Lorraine University, Paris Descartes University, Nancy, France.
3
Department of Neurology, Nancy University Hospital, Nancy, France.
4
National Institute for Occupational Safety and Health, Vandoeuvre-lès-Nancy, France.
5
Department of Neurology, Toulouse University Hospital, Toulouse, France.
6
Department of Neurology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
7
Department of Neurology, Lyon Hospices Civils - Pierre Wertheimer University Hospital, Lyon, France.
8
Department of Neurology, Rennes University Hospital, Rennes, France.
9
Ecoles des Hautes Etudes en Santé Publique, Rennes, France.
10
Department of Neurology, Dijon University Hospital, Dijon, France.
11
INSERM, CIC-EC, Nancy, France.

Abstract

INTRODUCTION:

Geographical variation in the prevalence of multiple sclerosis (MS) is controversial. Heterogeneity is important to acknowledge to adapt the provision of care within the healthcare system. We aimed to investigate differences in prevalence of MS in departments in the French territory.

METHODS:

We estimated MS prevalence on October 31, 2004 in 21 administrative departments in France (22% of the metropolitan departments) by using multiple data sources: the main French health insurance systems, neurologist networks devoted to MS and the Technical Information Agency of Hospitalization. We used a spatial Bayesian approach based on estimating the number of MS cases from 2005 and 2008 capture-recapture studies to analyze differences in prevalence.

RESULTS:

The age- and sex-standardized prevalence of MS per 100,000 inhabitants ranged from 68.1 (95% credible interval 54.6, 84.4) in Hautes-Pyrénées (southwest France) to 296.5 (258.8, 338.9) in Moselle (northeast France). The greatest prevalence was in the northeast departments, and the other departments showed great variability.

DISCUSSION:

By combining multiple data sources into a spatial Bayesian model, we found heterogeneity in MS prevalence among the 21 departments of France, some with higher prevalence than anticipated from previous publications. No clear explanation related to health insurance coverage and hospital facilities can be advanced. Population migration, socioeconomic status of the population studied and environmental effects are suspected.

PMID:
27936086
PMCID:
PMC5147922
DOI:
10.1371/journal.pone.0167556
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests: M. Debouverie has done consulting research and/or workshops for Biogen-Idec, Bayer-Schering, Genzyme, Merck-Serono, Novartis, Sanofi-Aventis and Teva Pharma. The organizations mentioned in this statement did not participate in any aspects of the design, execution, analysis, or write-up of this study. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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