Neurological Sciences

, Volume 39, Issue 7, pp 1231–1236 | Cite as

Multiple sclerosis in the Republic of San Marino, Italian peninsula: an incidence and prevalence study from a high-risk area

  • Marta Caniglia-Tenaglia
  • Susanna Guttmann
  • Chiara Monaldini
  • Dario Manzaroli
  • Mirco Volpini
  • Maurizio Stumpo
  • Elisabetta Groppo
  • Ilaria Casetta
  • Vittorio Govoni
  • Mattia Fonderico
  • Maura Pugliatti
  • Enrico GranieriEmail author
Original Article


Epidemiological studies on multiple sclerosis (MS) carried out in Southern Europe in the last years have shown a significant increase in the disease frequency. Previous surveys conducted in the Republic of San Marino, Northern Italian peninsula, identified that the population is at high risk for MS, with a prevalence of 51.6 per 100,000 population in 1982 and of 166.7 in 2005 and with a mean annual incidence of 7.9 per 100,000 for the period 1990–2005. The present work is a community-based intensive prevalence and incidence survey, by a complete enumeration approach, to update the prevalence and incidence of MS in the Republic of San Marino. The mean annual incidence for the period 2005–14 was 7.7 (95% CI 4.9–11.4) per 100,000, 3.3 (95% CI 1.1–7.6) for men and 11.9 (95% CI 7.2–18.6) for women. On 31 December 2014, 67 patients (19 men and 48 women), suffering from definite or probable MS and living in the Republic of San Marino, yielded a crude prevalence of 204.3 (95% CI 158.4–259.5) per 100,000, 117.8 (95% CI 70.9–183.7) for men and 288.2 (95% CI 212.4–383.3) for women. Our study has confirmed San Marino is an area at high risk for MS, in line with epidemiological data from continental Italy. The marked increase in MS prevalence over time in this population can be ascribable to increased survival and improved ascertainment, in the presence of a substantially stable, yet high, incidence rate.


Multiple sclerosis Epidemiology Incidence Prevalence Republic of San Marino 



The authors thank Eva Sjolin for her help in revising the translation of the text.

Funding information

This work is supported by Ferrara University (Fondo di Ateneo per la Ricerca).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Ethics approval for the study was obtained.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Marta Caniglia-Tenaglia
    • 1
  • Susanna Guttmann
    • 2
  • Chiara Monaldini
    • 2
  • Dario Manzaroli
    • 2
  • Mirco Volpini
    • 2
  • Maurizio Stumpo
    • 2
  • Elisabetta Groppo
    • 1
  • Ilaria Casetta
    • 1
  • Vittorio Govoni
    • 1
  • Mattia Fonderico
    • 1
  • Maura Pugliatti
    • 1
  • Enrico Granieri
    • 1
    Email author
  1. 1.Department of Biomedical and Specialty-Surgical Sciences, Section of Neurology, Psychology and PsychiatryUniversity of FerraraFerraraItaly
  2. 2.Unit of NeurologyState HospitalCailungoRepublic of San Marino

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