Epidemiology of multiple sclerosis in western Herzegovina and Herzegovina--Neretva Canton, Bosnia and Herzegovina.

The aim of this study was to investigate the selected indicators of multiple sclerosis (MS) in Herzegovina (Western Herzegovina Canton and Herzegovina-Neretva Canton). By using all available health and medical sources in the studied area and using McDonald's criteria, a total of 96 patients were identified in the period from 1996 to 2006. Results of the study show that the crude prevalence of MS was 30.99/100,000 (95% confidence interval [CIC 24.8-37.2), the highest one in the municipality of Posusje (49.6/100,000) and the lowest one in the municipalities of Neum and Ravno (no recorded cases); the female/male ratio was 1.5; the mean age of the patients on the prevalence day was 41.4 +/- 10.2 years and the mean age at the disease onset was 30.7 +/- 6.4 years; the most often clinical course of the disease was relapsing-remitting (58%), secondary progressive course was present in 28% patients, primary progressive in 9% and progressive relapsing in 1% of patients; the most frequent initial signs of the disease were motor (33%) and sensory ones (24%). According to the results of the study, the south-western part of Bosnia and Herzegovina is an area on the crossing from moderate risk to high risk zone for MS. The distribution of MS is heterogeneous. MS was more prevalent in the municipalities with colder climate and more winter precipitation and it is not present in the coastal region with warmer climate and almost without winter precipitation.