A matched case-control study of risk factors associated with multiple sclerosis in Kuwait

BMC Neurol. 2020 Feb 21;20(1):64. doi: 10.1186/s12883-020-01635-1.

Abstract

Background: Genetic and environmental factors seem to have etiologic roles in multiple sclerosis (MS). Kuwait is regarded as medium to high risk country for MS. However, there is a paucity of published data on the risk factors for MS in Kuwait. Therefore, this matched case-control study examined the association between various factors including family history, stressful life events, exposure to tobacco smoke, vaccination history, comorbidities and MS risk in Kuwait.

Methods: Confirmed 110 MS cases and age (± 5 years), gender and nationality matched controls (1:1) were enrolled. A pre-tested structured questionnaire was used to collect the data through face-to-face interviews both from cases and controls. Conditional logistic regression was used to analyze the data.

Results: Among both cases and controls, majority were Kuwaiti (82.7%), and female (76.4%). Multivariable model showed that cases compared to controls were significantly more likely to have had a family history of MS (adjusted matched odds ratio (mORadj) = 5.1; 95% CI: 2.1-12.4; p < 0.001) or less likely to have been vaccinated against influenza A and B viruses before MS onset (mORadj = 0.4; 95% CI: 0.2-0.8; p = 0.010). None of the other variables considered were significantly related to MS status in this study.

Conclusions: Family history of MS had significantly direct, whereas, vaccination against influenza A and B viruses had inverse associations with MS status. Future studies may contemplate to verify the observed results.

Keywords: Conditional logistic regression; Family history; Matched case-control study; Middle-east; Multiple sclerosis.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Comorbidity
  • Female
  • Humans
  • Kuwait / epidemiology
  • Male
  • Middle Aged
  • Multiple Sclerosis / epidemiology*
  • Risk Factors
  • Surveys and Questionnaires
  • Young Adult