Epidemiologic, Clinical and Socioeconomic Study of Cuban Women with Multiple Sclerosis

Multiple sclerosis is one of the main causes of disability among young Cuban women. The objective of these studies was to evaluate the clinical and social economic status of Cuban women with MS. First, an epidemiological case-control study was conducted among 50 women with clinically definite MS (by Poser criteria). The controls were women ranging from 15 to 65 years who were matched for age. Data collection forms were modified from Boiko's guidelines. Risk factors for MS included having two or more children (OR = 2.84; 95% CI = 1.22–6.59), acute stress (OR = 3.76; 95% CI = 1.64–8.62), and insomnia (OR = 2.95; 95% CI = 1.14–7.14).

A disability and socioeconomic analysis was conducted based on data from the Cuban Computed Register of MS (CUBARMS) of 271 women with clinically definite MS as defined by Poser or McDonald criteria. Most were between 31 and 50 years of age (61.2%) and Caucasian (73.06%). There were antecedents of familial psychiatric diseases (34.69%), neurological disorders (26.57%), general autoimmune diseases (21.7%), and MS (7.85%). Triggered factors at onset of MS were present in 56%, the most frequent being acute stress (52%). 169 patients (62.36%) drank coffee. Main initial symptoms of MS were weakness in limbs (51.66%); numbness of limbs (28.04%); poor balance (20.3%); blurred vision (18.81%); and paresthesias (18.81%). The most frequent symptoms of MS in women at the time of their medical consultation included weakness of limbs (71.59%); numbness (29.15%); paresthesias (28.41%); fatigue (24.73%); poor balance (23.62%); loss of vision (22.51%); rigidity (22.14%); blurred vision (17.71%); incontinence (16.97%); lack of coordination (16.24%); memory disorders (14.39%); and depression (12.92%).

Expanded Disability Status Scale (EDSS) scores ranged between 1 and 6.5 in 78.6% of patients, while Scripps Neurological Rating Scale (SNRS) scores ranged between 61 and 80 in 69.9%. In terms of social status, 58.3% were married; 33.9% were single or divorced; 32% had a high school education; 29.1% had university-level education, and 21% had secondary education. Over half (53.1%) were unemployed; 18% of female MS patients lived alone, and 48.6% received a monthly income between 100 and 401 pesos. The data gathered in these studies highlight the importance of improving knowledge of MS in Cuba, mainly in the primary care setting, in order to increase early diagnosis. With these data, we expect to achieve a better quality of life for female MS patients, thus improving their socioeconomic and work status. A program is in progress to improve the primary medical attention, disability, handicap, quality of life, and socioeconomic status of Cuban women with MS.