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Multiple Sclerosis Epidemiology in Middle East and North Africa: A Systematic Review and Meta-Analysis
Pouria Heydarpour1, Shayan Khoshkish, Shabnam Abtahi
1MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Multiple sclerosis (MS) is one of the most common neurological disorders and a leading cause of nontraumatic disability in young adults in many countries. Recent reports from the Middle East and North Africa have suggested a moderate to high risk of MS in these countries.
Methods:
A literature search was performed in August 2014 in MEDLINE, EMBASE, and IMEMR to retrieve original population-based studies on MS epidemiology in the Middle East and North African countries published between 1st January 1985 and 1st August 2014. We designed search strategies using the key words: MS, prevalence, incidence, and epidemiology. According to the inclusion criteria, 52 studies were included in this systematic review.
Results:
McDonald's criteria were the most widely used diagnostic criteria in the studies. Most studies were conducted in single hospital-based centers with a defined catchment area. The female/male ratio ranged from 0.8 in Oman to 4.3 in Saudi Arabia. MS prevalence ranged from 14.77/100,000 population in Kuwait (2000) to 101.4/100,000 in Turkey (2006). The overall MS prevalence in the region was 51.52/100,000. The mean age at disease onset ranged from 25.2 years in Kuwait to 32.5 years in Northeastern Iran, with an overall estimate of 28.54 years.
Conclusions:
Recent advances in MS registries will allow nation-wide studies and temporal comparisons between countries, provided that age- and sex-standardized estimates are available.
Insights
Multiple sclerosis (MS) risk is moderate to high in the Middle East and North Africa. This systematic review synthesizes MS epidemiology data from 52 studies, revealing prevalence and age of onset variations across the region.
Area of Science:
- Neurology
- Epidemiology
Background:
- Multiple sclerosis (MS) is a significant neurological disorder and a primary cause of disability in young adults.
- Recent data suggest a moderate to high risk of MS in the Middle East and North Africa (MENA) region.
Purpose of the Study:
- To systematically review the epidemiology of multiple sclerosis (MS) in the Middle East and North African countries.
- To consolidate prevalence, incidence, and demographic data for MS in the MENA region.
Main Methods:
- A comprehensive literature search was conducted in MEDLINE, EMBASE, and IMEMR databases up to August 2014.
- Included are 52 population-based studies on MS epidemiology published between 1985 and 2014.
- Search terms included "MS," "prevalence," "incidence," and "epidemiology."
Main Results:
- McDonald's criteria were predominantly used for MS diagnosis.
- MS prevalence varied significantly, from 14.77/100,000 in Kuwait to 101.4/100,000 in Turkey, with an overall regional estimate of 51.52/100,000.
- The mean age of MS onset was estimated at 28.54 years, ranging from 25.2 to 32.5 years across different countries.
Conclusions:
- The MENA region exhibits a notable burden of multiple sclerosis.
- Standardized, age- and sex-adjusted data are crucial for accurate national and regional MS comparisons.
- Advancements in MS registries can facilitate future nationwide epidemiological studies.
