Epidemiological Characteristics of Inflammatory Demyelinating Diseases of the Central Nervous System Including Multiple Sclerosis

A. V. Svetlichnaya
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Abstract

Relevance. Demyelinating diseases of the central nervous system and multiple sclerosis, in particular, make their debut at a young age and can lead to profound disability and death within a few years. In the last decade, there has been an increase in the number of cases of demyelinating diseases in Russia and in the world, which necessitates an in-depth study of these pathologies. Goal. To study the dynamics and features of the formation of morbidity, prevalence and mortality from demyelinating diseases of the central nervous system, including multiple sclerosis in various population groups in the Russian Federation. Materials and methods. The study design is a descriptive retrospective epidemiological study (continuous). The data was sampled from the forms of the federal state statistical observation on the distribution of the deceased by gender, age groups and causes of death of Rosstat (FSN S-51), as well as from the statistical collections of the Federal State Budgetary Institution "Central Research Institute of the Ministry of Health of the Russian Federation "Morbidity of the population" from 2009 to 2021. Results. The analysis of the data showed that in 2009-2021 in Russia there was an increase in idiopathic inflammatory demyelinating diseases (IDD) and multiple sclerosis (MS) among the adult population and adolescents aged 15 to 17 years. There is no tendency to increase or decrease the incidence among children under 14 years of age. The highest average long–term incidence rates of IDD and MS among adults are observed in the Ufa region (7.13 ± 0.27 and 5.31 ± 0.23 per 100 thousand adults, respectively), among children under 14 - IDD in the Central Federal District (1.88 ± 0.18 per 100 thousand contingent) and MS in the Central Federal District and Volga Federal District (0.22 ± 0.07 per 100 thousand contingent). Among children from 15 to 17 years of age, the highest incidence of IDD is noted in the Northwestern Federal District (4.41 ± 1.10 per 100 thousand contingent) and the Ural Federal District (4.40 ± 1.09 per 100 thousand contingent), RS – in the Central Federal District (2.67 ± 0.51 per 100 thousand contingent). IDD and MS are the least common among all age groups in the Far Eastern Federal District. Over the period from 2000 to 2020, there has been a decrease in MS mortality in the Russian Federation by 34%, from 0.72 to 0.48 per 100,000 population. The average annual mortality rate from MS among men was 0.4 ± 0.021 cases per 100 thousand of the contingent, among women 0.5 ± 0.023 cases per 100 thousand of the contingent. Conclusion. The increase in the incidence of demyelinating diseases and MS, in particular, is an important medical and social problem. These pathologies significantly reduce the quality of life and shorten the duration of work, due to the development of persistent disability in the young population. The study showed the uneven distribution of the disease across the territories of the Russian Federation, which in the future will improve the logistics of drug delivery and the provision of medical personnel, which confirms the relevance of constant and in-depth study of the epidemiology of idiopathic inflammatory demyelinating diseases in Russia.
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包括多发性硬化症在内的中枢神经系统炎症性脱髓鞘疾病的流行病学特征
相关性。中枢神经系统脱髓鞘疾病,尤其是多发性硬化症,会在患者年轻时发病,并在数年内导致严重残疾和死亡。近十年来,脱髓鞘疾病的病例在俄罗斯和全世界都有所增加,因此有必要对这些病症进行深入研究。目标。研究中枢神经系统脱髓鞘疾病(包括多发性硬化症)在俄罗斯联邦不同人群中的发病率、流行率和死亡率的形成动态和特点。材料和方法研究设计为描述性回顾流行病学研究(连续性)。数据取自俄罗斯联邦国家统计观察表(FSN S-51)中按性别、年龄组和死亡原因分列的死者分布情况,以及联邦国家预算机构 "俄罗斯联邦卫生部中央研究所 "2009-2021 年 "人口发病率 "统计资料。研究结果数据分析显示,2009-2021年俄罗斯成年人和15-17岁青少年中特发性炎症性脱髓鞘疾病(IDD)和多发性硬化症(MS)的发病率有所上升。14 岁以下儿童的发病率没有增减趋势。成年人中多发性硬化症和多发性硬化症的长期平均发病率最高的地区是乌法州(分别为每 10 万成年人 7.13 ± 0.27 和 5.31 ± 0.23),14 岁以下儿童中多发性硬化症发病率最高的地区是中央联邦区(每 10 万特遣队 1.88 ± 0.18),多发性硬化症发病率最高的地区是中央联邦区和伏尔加河联邦区(每 10 万特遣队 0.22 ± 0.07)。在 15 至 17 岁的儿童中,IDD 的发病率最高的是西北联邦区(每 10 万人中有 4.41 ± 1.10 人)和乌拉尔联邦区(每 10 万人中有 4.40 ± 1.09 人),RS 的发病率最高的是中央联邦区(每 10 万人中有 2.67 ± 0.51 人)。在远东联邦区的所有年龄组中,IDD 和多发性硬化症的发病率最低。从 2000 年到 2020 年,俄罗斯联邦的多发性硬化症死亡率下降了 34%,从每 10 万人 0.72 例降至 0.48 例。男性多发性硬化症的年平均死亡率为每 10 万特遣队中 0.4 ± 0.021 例,女性为每 10 万特遣队中 0.5 ± 0.023 例。结论脱髓鞘疾病,尤其是多发性硬化症发病率的上升是一个重要的医疗和社会问题。这些疾病大大降低了生活质量,缩短了工作时间,原因是年轻人中出现了持续性残疾。研究显示,该疾病在俄罗斯联邦境内的分布不均衡,这将在未来改善药物输送的物流和医疗人员的提供,这也证实了在俄罗斯不断深入研究特发性炎症性脱髓鞘疾病流行病学的意义。
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