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Spatial analysis of global prevalence of multiple sclerosis suggests need for an updated prevalence scale
1Department of Therapist Assistant, Okanagan College, 1000 KLO Road, Kelowna, BC, Canada V1Y 4X8.
Abstract:
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system with an unknown aetiology. MS has a geographic pattern of prevalence with high prevalence rates between 45 degrees and 65 degrees north. In much of the northern hemisphere, there exists a prevalence gradient, with increasing prevalence from south to north. While genetics may partially explain the latitudinal gradient, it is not strong enough to exclude exogenous variables. Kurtzke initially came up with a three-zone scale for low, medium, and high prevalence zones. He defined high as 30 or more per 100,000, medium as 5-29 per 100,000, and low as less than 5 per 100,000. In this study, 131 geographic datasets (geocases) were spatially analyzed to determine whether the existing global prevalence scale needed to be updated. The mean prevalence rate was 67.83/100,000 with rates ranging from 350/100,000 to 0/100,000. The results of this study suggest that the commonly referenced scale for global MS prevalence needs to be updated with added zones to reflect significantly higher prevalence rates in some areas of the world. We suggest a five-zone scale: very high (170-350), high (70-170), medium (38-70), low (13-38), and very low (0-13).
Insights
This study revises the global multiple sclerosis (MS) prevalence scale. New data reveal higher rates, necessitating an updated five-zone classification for accurate geographic analysis of MS.
Area of Science:
- Epidemiology
- Neurology
- Geographic Information Systems (GIS)
Background:
- Multiple sclerosis (MS) is a central nervous system demyelinating disease with an unknown cause.
- MS exhibits a latitudinal prevalence gradient, increasing from south to north in the Northern Hemisphere.
- Existing global prevalence scales may not accurately reflect current MS distribution patterns.
Purpose of the Study:
- To spatially analyze geographic datasets (geocases) of MS prevalence.
- To determine if the existing global MS prevalence scale requires updating.
- To propose a revised scale for classifying global MS prevalence zones.
Main Methods:
- Spatially analyzed 131 geographic datasets (geocases).
- Calculated mean and range of MS prevalence rates.
- Compared current findings with established prevalence scales.
Main Results:
- The mean MS prevalence rate observed was 67.83 per 100,000, with rates varying from 0 to 350 per 100,000.
- Current prevalence rates in some regions exceed those accounted for by existing scales.
- The study identified the need for an updated, more granular prevalence scale.
Conclusions:
- The commonly referenced global MS prevalence scale requires revision.
- A new five-zone scale (very high, high, medium, low, very low) is proposed.
- The updated scale better reflects the observed higher prevalence rates in certain global areas.
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