HTLV-I-associated myelopathy tropical spastic paraparesis in Brazil: A nationwide survey

To study the epidemiology of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Brazil, we conducted a nationwide survey between M arch 1994 and April 1995. Five centers from three regions of the country pa rticipated, enrolling 163 patients. Most patients came from the northeaster n and southeastern regions (93.2%). Most enrollees were white women, 42.9% and 64.4%, respectively. The most common risk factors for infection include d a history of venereal diseases (30.6%) and blood transfusion (21.6%). The median age at the beginning of the disease was 42 years. The main neurolog ic findings were spastic paraparesis, widespread brisk tendon jerks, bilate ral Babinski's sign, and bladder dysfunction. Some interregional difference s reached statistical significance. The ratio of females over males increas ed from south to north. In addition, in both southern and southeastern regi ons, whites prevailed, whereas in the northeast, mulattos predominated. Thi s follows the normal distribution of the population in these regions. A sig nificantly higher rate of venereal diseases was found in the southeast comp ared with the other regions studied. A history of intravenous drug use was more frequent among patients as the sample moves south. Finally, a fluctuat ing course of the disease was proportionally more frequent in the southern region.