Multiple sclerosis burden: global versus MENA region (1990 to 2023), with mortality projections to 2050: A pairwise GBD analysis
Related Experiment Videos
Mohammed N Aljabr1, Obadh A Almushiqh1, Rayan S Alsaud1
1Department of Medicine, College of Medicine, Qassim University, Buraydah, 52571, Saudi Arabia.
Introduction:
Multiple sclerosis (MS) burden is rising in the Middle East and North Africa (MENA), a region long considered low-prevalence. This study compared MS mortality, incidence, and prevalence between MENA and global populations from 1990 to 2023.
Methods:
GBD 2023 age-standardized mortality (ASMR), incidence (ASIR), and prevalence (ASPR) rates for 21 MENA countries and globally were analyzed with joinpoint regression, comparing average annual percentage changes (AAPC) with z-tests adjusted for MENA's inclusion in the global estimate. Death counts were decomposed into population growth, ageing, and ASMR change, and country trends were stratified by income group and subregion.
Results:
Global ASMR declined from 0.23 to 0.21 per 100,000 (AAPC -0.28%), whereas MENA ASMR rose from 0.14 to 0.24 (AAPC +1.67%; p < 0.001 versus global), although its GBD uncertainty interval included zero. Global deaths rose 97% through population growth (+52%) and ageing (+42%) despite a 9% ASMR decline; MENA deaths rose 376% through population growth (+99%), ageing (+40%), and rising ASMR (+71%). MENA incidence (AAPC +0.33% vs -0.03%) and prevalence (+0.54% vs +0.26%) outpaced global rates, and female mortality in MENA outpaced male mortality (+2.22% vs +0.97%). Country trends did not differ by income group or subregion. By 2050, mortality was projected to fall 26.3% globally against 10.5% in MENA.
Conclusions:
Age-standardized MS incidence and prevalence are rising in MENA, more so in females, while global trends remain largely stable. Rising deaths in both populations largely reflect population growth and ageing. MS registries, disease-modifying therapy access, and neurorehabilitation investment are needed.
