Introduction
Materials and methods
Design and data sources
Algorithm to identify MS cases
Statistical analysis
Prevalence
Mortality rate
Results
Description of the population
Prevalence
Age | Number of MS cases | Number of people residing in France | Overall | Women | Men | |||
---|---|---|---|---|---|---|---|---|
MS crude prevalence | 95% confidence interval | MS crude prevalence | 95% confidence interval | MS crude prevalence | 95% confidence interval | |||
Total France | 99,123 | 65,542,916 | 151.2 | 150.3–152.2 | 210.0 | 208.4–211.5 | 88.7 | 87.6–89.7 |
Under 15 | 136 | 12,164,564 | 1.1 | 0.9–1.3 | 1.3 | 1.0–1.6 | 0.9 | 0.7–1.2 |
15–19 | 490 | 3,957,475 | 12.4 | 11.3–13.5 | 17.7 | 15.8–19.6 | 7.3 | 6.1–8.5 |
20–24 | 1821 | 3,963,556 | 45.9 | 43.8–48.1 | 64.2 | 60.7–67.8 | 27.9 | 25.6–30.3 |
25–29 | 4481 | 3,925,169 | 114.2 | 110.8–117.5 | 166.2 | 160.5–171.8 | 60.7 | 57.2–64.2 |
30–34 | 7416 | 4,105,931 | 180.6 | 176.5–184.7 | 256.7 | 249.9–263.6 | 102.1 | 97.7–106.5 |
35–39 | 9113 | 4,164,014 | 218.9 | 214.4–223.3 | 313.5 | 306.0–321.1 | 122.8 | 118.0–127.6 |
40–44 | 11,542 | 4,559,827 | 253.1 | 248.5–257.7 | 360.8 | 353.0–368.5 | 143.7 | 138.7–148.6 |
45–49 | 13,213 | 4,542,473 | 290.9 | 285.9–295.8 | 411.1 | 402.9–419.4 | 167.1 | 161.7–172.4 |
50–54 | 12,998 | 4,364,041 | 297.8 | 292.7–303.0 | 425.9 | 417.3–434.4 | 164.3 | 158.9–169.7 |
55–59 | 11,672 | 4,173,094 | 279.7 | 274.6–284.8 | 384.5 | 376.2–392.8 | 168.1 | 162.4–173.7 |
60–64 | 10,391 | 4,108,440 | 252.9 | 248.1–257.8 | 337.6 | 329.8–345.3 | 161.7 | 156.1–167.3 |
65–69 | 6666 | 3,221,653 | 206.9 | 202.0–211.9 | 271.7 | 263.9–279.6 | 135.5 | 129.7–141.3 |
70–74 | 3827 | 2,368,290 | 161.6 | 156.5–166.7 | 212.5 | 204.6–220.5 | 101.3 | 95.3–107.3 |
75–79 | 2712 | 2,228,492 | 121.7 | 117.1–126.3 | 154.6 | 147.8–161.4 | 77.4 | 71.9–83.0 |
80–84 | 1641 | 1,864,716 | 88.0 | 83.7–92.3 | 109.0 | 103.0–115.1 | 54.4 | 49.0–59.8 |
85 plus | 860 | 1,831,181 | 47.0 | 43.8–50.1 | 54.0 | 49.9–58.0 | 30.9 | 26.3–35.5 |
Overall | Women | Men | |
---|---|---|---|
Number of MS cases | 99,123 | 70,963 | 28,148 |
2012 population | 65,542,916 | 33,795,692 | 31,747,224 |
Crude prevalence rates per 100,000 population | 151.2 (150.3–152.2) | 210.0 (208.4–211.5) | 88.7 (87.6–89.7) |
Standardized prevalence rates per 100,000 world population | 117.4 (116.6–118.1) | 165.9 (164.6–167.1) | 68.9 (68.0–69.7) |
Standardized prevalence rates per 100,000 1976-European population | 144.1 (143.2–145.0) | 203.3 (201.8–204.8) | 85.0 (83.9–86.0) |
Standardized prevalence rates per 100,000 2013-European population | 155.6 (154.7–156.6) | 218.5 (216.9–220.2) | 92.7 (91.6–93.8) |
Administrative region of France | Number of MS cases | Number of people living in the region | Overall | Women | Men | |||
---|---|---|---|---|---|---|---|---|
MS standardized prevalence | 95% confidence interval | MS standardized prevalence | 95% confidence interval | MS standardized prevalence | 95% confidence interval | |||
Total Francea
| 99,123 | 65,542,916 | 151.2 | 150.3–152.2 | 210.0 | 208.4–211.5 | 88.7 | 87.6–89.7 |
Lorraine | 4785 | 2,350,657 | 200.2 | 194.6–205.9 | 277.9 | 268.6–287.3 | 117.5 | 111.3–123.7 |
Picardie | 3701 | 1,924,737 | 193.8 | 187.5–200.0 | 272.7 | 262.4–283.1 | 109.7 | 102.9–116.4 |
Alsace | 3636 | 1,861,020 | 192.6 | 186.3–198.8 | 269.5 | 259.2–279.9 | 110.7 | 103.9–117.4 |
Nord-Pas-de-Calais | 7531 | 4,052,156 | 190.6 | 186.3–194.9 | 255.0 | 248.1–261.9 | 122.0 | 117.1–127.0 |
Champagne-Ardenne | 2544 | 1,333,497 | 190.3 | 182.9–197.7 | 267.6 | 255.3–279.8 | 108.0 | 100.0–115.9 |
Franche-Comté | 2180 | 1,177,906 | 185.7 | 177.9–193.5 | 270.6 | 257.4–283.7 | 95.4 | 87.4–103.3 |
Bourgogne | 2855 | 1,643,931 | 170.1 | 163.8–176.4 | 247.2 | 236.7–257.7 | 88.1 | 81.6–94.5 |
Centre | 4385 | 2,572,931 | 169.3 | 164.3–174.3 | 239.0 | 230.7–247.3 | 95.1 | 89.7–100.5 |
Auvergne | 2170 | 1,355,630 | 155.0 | 148.4–161.6 | 224.9 | 213.8–235.9 | 80.6 | 73.9–87.3 |
Haute-Normandie | 2779 | 1,848,102 | 150.8 | 145.2–156.4 | 205.4 | 196.3–214.5 | 92.7 | 86.4–99.1 |
Ile-de France | 17,413 | 11,978,363 | 149.2 | 147.0–151.4 | 202.1 | 198.4–205.7 | 92.9 | 90.4–95.5 |
Basse-Normandie | 2213 | 1,479,242 | 148.0 | 141.8–154.2 | 205.6 | 195.4–215.8 | 86.7 | 79.9–93.4 |
Bretagne | 4786 | 3,259,659 | 146.6 | 142.4–150.8 | 206.6 | 199.7–213.5 | 82.7 | 78.2–87.1 |
Limousin | 1118 | 741,047 | 144.5 | 136.0–153.1 | 210.3 | 195.9–224.7 | 74.5 | 65.8–83.3 |
Midi-Pyrénées | 4223 | 2,946,507 | 141.2 | 136.9–145.5 | 199.2 | 192.1–206.2 | 79.5 | 74.9–84.0 |
Provence-Alpes-Côte d’Azur | 7128 | 4,937,445 | 141.2 | 137.9–144.4 | 193.9 | 188.5–199.2 | 85.1 | 81.4–88.8 |
Rhône-Alpes | 8862 | 6,393,470 | 140.4 | 137.4–143.3 | 192.6 | 187.9–197.4 | 84.7 | 81.4–87.9 |
Pays de la Loire | 5019 | 3,658,351 | 139.4 | 135.6–143.3 | 200.3 | 193.9–206.8 | 74.6 | 70.5–78.6 |
Aquitaine | 4669 | 3,303,392 | 137.1 | 133.2–141.0 | 193.4 | 186.9–199.9 | 77.2 | 72.9–81.4 |
Languedoc-Roussillon | 3689 | 2,727,286 | 133.1 | 128.7–137.4 | 186.6 | 179.5–193.7 | 76.0 | 71.3–80.7 |
Poitou–Charentes | 2401 | 1,792,159 | 130.1 | 124.9–135.3 | 186.6 | 177.8–195.3 | 70.0 | 64.5–75.5 |
Corse | 422 | 322,120 | 125.6 | 113.6–137.6 | 176.2 | 156.3–196.1 | 71.8 | 58.9–84.8 |
Martinique | 207 | 386,486 | 49.4 | 42.5–56.2 | 69.8 | 58.8–80.8 | 27.6 | 19.7–35.4 |
Guadeloupe | 159 | 405,739 | 37.7 | 31.8–43.7 | 51.4 | 42.0–60.9 | 23.1 | 16.0–30.3 |
Guyane | 39 | 250,109 | 24.6 | 15.1–34.0 | 35.0 | 19.2–50.7 | 13.6 | 3.5–23.6 |
Réunion | 177 | 840,974 | 22.9 | 19.3–26.4 | 26.7 | 21.3–32.0 | 18.8 | 14.2–23.5 |
Mortality rate
Discussion
Principal findings of the study
Comparison with French and European estimates of MS prevalence in the literature
Author | Year of the study | Data sources and methodology | MS prevalence (per 100,000 inhabitants) with its 95% confidence interval, when available | Strengths and limits |
---|---|---|---|---|
Vukusic [4] | 2003 | Identification of MS patients using the LTD diagnosis in the French agricultural workers health insurance system database. Prevalence standardized using the age structure of the French population | Age-standardized prevalence: 65.0 (62.5–67.5) | Strengths: nationwide estimation Limits: lack of representativeness. Only 7% of the French population is covered by the agricultural workers health insurance system. LTD status for MS may not be sufficiently sensitive to identify all MS cases |
Fromont [3] | 2004 | Identification of MS patients using the LTD diagnosis in the General Scheme health insurance system database. Prevalence standardized using the age structure of the French population | Age-standardized prevalence: 94.7 (94.3–95.1) Higher rates in North-Eastern versus South-Western regions | Strengths: nationwide estimation, population more representative of the French population than in Vukusic paper Limits: LTD status for MS may not be sufficiently sensitive to identify all MS cases |
Sagnes-Raffy [6] | 2005 | Identification of MS patients by matching several data sources by a capture-recapture method in Haute Garonne, a department in the South West of France. The data were hospital data, LTD status and reimbursement of specific treatments of MS using local health insurance data, and data from a MS health network | Modelled prevalence using the capture-recapture method: 138–149 | Strengths: multisource and independent data collection Limits: local estimation |
El Adssi [5] | 2008 | Identification of MS patients by matching several data sources by a capture-recapture method in Lorraine, a region in the North East of France. The data were hospital data, LTD status and reimbursement of specific treatments of MS using local health insurance data, and data from the Lorraine registry of MS | Crude prevalence: 170.9 (165.7–176.3) Modelled prevalence using the capture-recapture method: 188.2 (182.7–193.8) | Strengths: multisource and independent data collection Limits: local estimation |