Multiple sclerosis in Trinidad and Tobago - abstract

ABSTRACT

No studies have been reported on the incidence or prevalence or multiple sclerosis in Trinidad and Tobago. This paper reports on 15 cases presenting between 1976 and 1986, seen either at the Port-of-Spain General Hospital (9) or privately (6) by one of us (P.R.). All the cases fit into one of the categories defined by Poster et al (1983) 3 are laboratory supported, definite; 9 are clinically definite; and 3 are clinically probable. One is an expatriate who was born and lived in Scotland for more than 30 years. Fourteen were born in the West Indies - 3 in Jamaica and 11 in Trinidad. The male female ratio is 122. Of the 11 patients from Trinidad, 4 are of East Indian origin; 1 of African origin and 6 mixed (at least 1 grandparent white). Of the 3 born in Jamaica, 2 are mixed and one probably of pure African origin. The age of onset of symptoms was between 11 and 39 years. Most of the patients were diagnosed within 2 years of their first symptoms. Three died, 2 of African origin (aged 37 and 43), both 6 years after diagnosis and 1 East Indian, 4 years after diagnosis. Of the 14 West Indian born patients, 64 percent presented with visual symptoms; 78 percent had optic neuritis/atrophy during the illness. In temperate climates, the prevalence of optic neuritis is 25-40 percent. Tests for HTLV-1 antibodies were done in 8 patients; 1 case was positive. CSF from 5 patients was examined for oligoclonal banding and 3 were positive. The fact that 8 of the 14 patients are of mixed (African and White) ancestry is a point in favour of some predisposing gene from a white ancestor (AU)