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Prevalence of Multiple Sclerosis: Door-to-Door Survey in Three Rural Areas of Coastal Black Sea Regions of TurkeyTürk Börü Ü.a · Taşdemir M.b · Güler N.a · Dilaver Ayık E.a · Kumaş A.a · Yıldırım S.a · Duman A.a · Sur H.c · Kurtzke J.F.d
aNeurology Clinic, Dr. Lütfi Kindar Kartal Training and Research Hospital, bDepartment of Public Health, Marmara University Faculty of Medicine, and cDepartment of Health Management, Marmara University Faculty of Health Sciences, Istanbul, Turkey; dDepartment of Neurology, Georgetown University, Washington, D.C., USA
Background: Little information exists on multiple sclerosis (MS) in Turkey. With a door-to-door survey in an urban part of Istanbul, we recently reported a prevalence rate of 101/100,000 population. We therefore investigated three rural areas of Turkey at the same latitude. Methods: The same survey methods were used for total populations of two rural areas (Kandıra and Geyve) near Istanbul, and for half the population of Erbaa, all near 40° north latitude on the Black Sea coast. Results: In Kandıra, 5 of 8 suspects were diagnosed as having MS among 8,171 screened, resulting in a prevalence rate of 61/100,000. Geyve with 7 MS cases in 17,016 screened had a prevalence of 41/100,000, and Erbaa with 15 MS cases in 28,177 screened one of 53/100,000. Together they showed a prevalence of 51/100,000. Of the 27 patients, 20 were women; 25 had definite and 2 possible MS, the former all with abnormal laboratory findings. Average ages were 30.5 years at onset and 39.1 years at diagnosis. Clinical features and course were typical of European MS. Conclusion: These findings indicate that Turkey is a high-risk MS area, similar to most regions of Mediterranean Europe, where all recent increases are likely due to (undefined) environmental factors.
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