The Prevalence of Huntington Disease in Asia Highlights Needs in Clinical, Genetic and Instrumental Diagnosis: A Systematic Review and Meta-Analysis

The epidemiological analyses on Huntington's Disease (HD) indicate that prevalence rates in the Asian population are significantly lower than in the Western population. The research aims to explore the prevalence of HD in Asian countries. Point Prevalence (PP) is equivalent to the number of people affected by HD per 100,000 inhabitants. A meta-analysis was completed on prevalence rates to extract the global PP and the degree of heterogeneity of I² to confirm or discard similarities of PP of HD in Asian countries. Nine major studies were identified. A random-effect meta-analysis showed PP prevalence in Asia of 0.52 (CI95%=0.36-0.75). There is also a significant difference between PP of Asia vs Europe (p<0.001), confirming a lower prevalence of HD in Asian countries except for Pakistan, Punjab, and Gujarat, which have the higher prevalence in Asia. Our study reveals that Huntington's Disease affects Asia's population with variable figures globally to a lesser extent than Europe, although some Middle East countries present the highest global prevalence. The possible reasons are explored. The following are take-home messages derived from the current study. HD in Asia shows a point prevalence lower than European Countries, probably due to differences in clinical, instrumental and diagnostic procedures. Stigma linked to HD and its impact on family and society can reduce people's mindfulness to undergo targeted assessment. Further research is required to estimate the true prevalence of HD worldwide and promote better diagnostic screening using genetic testing. The true prevalence of HD is probably underestimated, and there is the need to provide education in the general population about this condition and testing.