Improving a Case-Control Study of Multiple Sclerosis Using Formative Research.

Formative research (i.e. focus groups and key informant interviews) was conducted to understand risk perceptions and identify barriers to participation in a case-control study of environmental exposures and genetic susceptibility as risk factors for multiple sclerosis (MS).

The prevalence of multiple sclerosis in 3 US communities.

Introduction: We estimated the prevalence of multiple sclerosis (MS) in 3 large geographic areas in the southern, middle, and northern United States.

Methods: The primary data source was medical records from office visits to private neurologists' practices or to neurology departments in tertiary care facilities during a 3-year period. Additional data sources included patient advocacy groups, nursing homes, and general practitioners.

Maternal pesticide exposure and neural tube defects in Mexican Americans.

Purpose: The relation between maternal pesticide exposures and neural tube defects (NTDs) in offspring was evaluated in 184 Mexican American case-women and 225 comparison women.

Methods: In-person interviews solicited information about environmental and occupational exposures to pesticides during the periconceptional period.

Results: With adjustment for maternal education, smoking, and folate intake, women who reported using pesticides in their homes or yards were two times more likely (95% confidence interval [CI], 1.

Updated prevalence estimates of multiple sclerosis in Texas, 1998 to 2003.

The Texas Department of State Health Services extended a prevalence study of multiple sclerosis (MS) in a 19-county area in North Texas to include 3 additional years of data and included a new geographic area with a predominantly Hispanic population (El Paso County). Patients in whom MS was diagnosed by a neurologist, who resided in the study areas, and who had an office visit between 1998 and 2003 were included in the study. The 6-year MS prevalence estimate for the North Texas counties was 71.

Prevalence of multiple sclerosis in 19 Texas counties, 1998-2000.

The study reported here determined the prevalence of multiple sclerosis (MS) between January 1, 1998, and December 31, 2000, for a 19-county study area surrounding Lubbock, Texas. The primary data source for case ascertainment was medical records from the offices of neurologists practicing in the study area. The study found that the overall prevalence for the 19-county study area was 42.

Investigation of a cluster of multiple sclerosis in two elementary school cohorts.

The authors investigated a cluster of multiple sclerosis (MS) among people who had attended two elementary schools in El Paso, Texas, from 1948 through 1970. The community was concerned about the possibility of childhood exposure to heavy metals from a large nearby smelter because historical environmental and biological sampling data demonstrated the potential for study cohort members to have been exposed to heavy metals during their pre-adolescent years. One cohort had no reported cases of MS.

Including residents in epidemiologic studies of adverse health effects in communities with hazardous exposures.

For individuals who live within the shadows of hazardous waste sites, there is a constant worry about what impact releases from these sites are having on their health and environment. Public health agencies at the local, state, and federal levels are routinely asked to investigate these concerns and determine what, if any, exposures are occurring or may have occurred in the past, and what the health risk to nearby residents may be. To ensure the credibility of research findings, full participation of affected communities is needed.

Challenges in addressing community concerns regarding clusters of multiple sclerosis and potential environmental exposures.

Citizens living around hazardous waste sites in the USA have expressed concern to public health officials at the local, state and federal level about a perceived high prevalence of multiple sclerosis (MS) in their communities. Many believe the occurrence of the disease is directly linked to exposure to chemical agents from the nearby hazardous waste site. Although the public's concern regarding these clusters should be addressed, epidemiologists have long known that evaluating perceived clusters is rarely fruitful for identifying an etiologic agent.