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Incidence and prevalence of multiple sclerosis in the Americas: a systematic review

Charity Evans1, Sarah-Gabrielle Beland, Sophie Kulaga

  • 1Division of Neurology, University of British Columbia, Vancouver, B.C., Canada. charity.evans@usask.ca

Neuroepidemiology
|February 1, 2013
PubMed
Abstract

Insights

This review found significant gaps and inconsistencies in multiple sclerosis (MS) epidemiological studies across the Americas. Future research needs standardized methods and national-level data for accurate MS incidence and prevalence. Keywords: multiple sclerosis, MS, epidemiology, incidence, prevalence, Americas.

Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Multiple sclerosis (MS) exhibits significant global variations in incidence and prevalence.
  • No prior comprehensive review has synthesized MS epidemiology across the Americas.
  • Existing data on MS distribution in North, Central, and South America is fragmented.

Purpose of the Study:

  • To systematically review and critically assess the quality of studies estimating MS incidence and/or prevalence in the Americas.
  • To identify gaps and inconsistencies in the epidemiological research of MS across North, Central, and South America.

Main Methods:

  • Conducted a comprehensive literature search of MEDLINE and EMBASE (January 1985–January 2011).
  • Included full-text articles in English or French using keywords: 'multiple sclerosis', 'incidence', 'prevalence', 'epidemiology'.
  • Assessed study quality using a validated, study-specific tool based on recognized guidelines.

Main Results:

  • Identified 31 studies meeting inclusion criteria from 3,925 initial records; 25 focused on North America.
  • Observed high heterogeneity among studies, even within countries, complicating comparisons.
  • Only 50% of studies reported standardized rates; quality scores varied significantly (3/8 to 8/8).

Conclusions:

  • Significant gaps and methodological inconsistencies persist in the epidemiological knowledge of MS in the Americas.
  • Future MS incidence and prevalence studies require uniform case definitions, comparable ascertainment methods, and standardized, national-level reporting.
  • Consideration of factors like sex distribution, ethnicity, and lifestyle is crucial for comprehensive MS epidemiology.

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