An Analysis of the Number of Attacks in Multiple Sclerosis Patients Using Zero-inflated Negative Binomial model

Document Type: Original Article


1 Student's Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran.

2 Isfahan Neurosciences Research Center. Alzahra Research institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Dept. of Epidemiology and Biostatistics, School of Health, Shahrekrod University of Medical Sciences, Shahrekrod, Iran

4 Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran. (* Corresponding author)


Introduction: Multiple Sclerosis is an inflammatory disease of the central nervous system. The impact of the number of attacks on the disease is undeniable. The aim of this study was to analyses the Number of Attacks in these patients.
In this descriptive-analytical study, the registered data of 1840 MS patients referring to the MS Clinic of Ayatollah Kashani Hospital in Isfahan was used. The number of attacks during the treatment period was defined as the response variable and age of diagnosis, sex, employment, level of education, marital status, Family history, course of disease and expanded disability as the explanatory variables. The analysis was performed using Zero-Inflated negative binomial model via Bayesian framework by OpenBUGS software.
Age of diagnosis, marital status, level of education, job, and course of disease had a significant effect on the number of attacks. In relapsing- remitting patients, the number of attacks was significantly affected by expanded disability.
Aging, single(never married), high education and no having a job decreases the number of attack; therefore, patients with lower age, to marriage, primary educated and housewives are in high risk group. An interventional or educational program is suggested in high risk groups of patients in order to prevent them from occurring further attacks and increase their chance of recovery.