Epidemiological aspects of multiple sclerosis in the Republic of Moldova

Abstract

Introduction: Multiple sclerosis is a chronic disorder of the central nervous system, manifesting as acute focal inflammatory demyelination and axonal loss, and culminating with chronic multifocal sclerotic plaques. MS involves several nervous functional systems resulting in disability, has a rather unpredictable course, and thus leads to poorer quality of life. It is a disorder of young adults, and the most common cause of non post-traumatic neurological disability. It is considered to be caused by such factors as: genetics factors, vaccines, stress, occupation, climate and nutrition. Purpose and objectives: To determine the epidemiological aspects of the Multiple Sclerosis in the Republic of Moldova. Materials and methods: The present work involves epidemiological descriptive studies aimed at disclosing clues to disease clinical state and predominance of this by sex, age, medium and region in the Republic of Moldova. All these were studied at 110 patients using their medical cards and electronic informations. Also a part of them were examined by specific neurological examination and were analyzed by investigations that still continue. Results: Multiple Sclerosis was diagnosticated in 72 (65,45%) men and 38 (34,54%) women. The medium age was approximately 39,73. Also the age, which was frequently affected, is the first 41-50 (31,81%) and the second 31-40 (30%). But, the first symptoms were present at the age of 26-30. In this study were divided patients by the medium- urban -41,81% and rural 58,18%; and also by regions: north- 16%, center -55%, and south-29%. The patients with multiple sclerosis were analized by the EDSS (Expanded Disability Status Scale), so we obtained the following results: the maximum percentage -36,36 % (3.5- 5,0) was typical for 40 patients and the minimum 3,63 %(8,5-9,0) - only for 4 patients. The common patterns of MS were categorized as follows: relapsing-remitting- 46,36%, secondary progressive- 32,72%, primary progressive- 20,90%. Common symptoms of MS include fatigue, weakness, spasticity, balance problems, bladder and bowel problems, numbness, vision loss, tremors and depression. The treatment used was: Interferon/ Rebif-3 (2,72%), Azatioprin/ Imuran- 11 (10%), Mitoxantron- 5 (4,54%), Metilprednisolon- 51 (46,36%), Copaxone/ Glutamirat acetat- -4 (3,36%), plasmopheresis- 9 (8,18%). And one of the important aspect is that from total number of patient 110,only 12 persons (11%) have a job,and go to work everyday. Conclusion: This project is limited because at the moment, in the Republic of M oldova, approximately 450 persons are diagnosed with MS, but there were analized only 110. However, epidemiological aspects showed that MS is an important disease and its evolution depends on the different factors as: age, gravidity of symptoms, sex, medium, region and type of treatment.