N Makhani1, S A Morrow2, J Fisk3, C Evans4, S G Beland5, S Kulaga5, E Kingwell6, J J Marriott7, J Dykeman8, N Jetté9, T Pringsheim10, C Wolfson11, R A Marrie7, M W Koch12. 1. Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada. Electronic address: naila.makhani@sickkids.ca. 2. Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada. 3. Department of Psychiatry, Dalhousie University, Halifax, Canada; Department of Medicine, Dalhousie University, Halifax, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Canada. 4. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada. 5. Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada. 6. Division of Neurology, University of British Columbia, Vancouver, Canada. 7. Department of Internal Medicine, University of Manitoba, Winnipeg, Canada. 8. Department of Community Health Sciences, University of Calgary, Calgary, Canada. 9. Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Institute for Public Health, University of Calgary, Calgary, Canada. 10. Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Institute for Public Health, University of Calgary, Calgary, Canada; Department of Pediatrics, University of Calgary, Calgary, Canada. 11. Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Epidemiology & Biostatistics, McGill University, Canada; Department of Medicine, McGill University, Canada. 12. Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Institute for Public Health, University of Calgary, Calgary, Canada.
Abstract
OBJECTIVES: Studies of multiple sclerosis (MS) incidence and prevalence from Africa, Asia, Australia and New Zealand are relatively scarce. We systematically reviewed MS incidence and prevalence in these regions including a standardized evaluation of study quality. METHODS: We searched MEDLINE and EMBASE databases for studies of MS prevalence or incidence in Africa, Asia, Australia and New Zealand published in English or French between January 1, 1985 and January 31, 2011. Study quality was assessed using a standardized tool. All steps of the review were performed in duplicate. RESULTS: Of 3925 citations identified, 28 studies met inclusion criteria and 21 of these were from Asia. Quality scores ranged from 1/8 to 8/8; the lowest scores were observed in studies from Asia (median 4/8, IQR 3,6). Prevalence was lowest in South African Blacks (0.22/100,000) and highest amongst Australian-born individuals in Australia (125/100,000). Prevalence increased over time in many countries. MS prevalence increased with increasing latitude only in some regions, and prevalence varied significantly with ethnicity. Eight studies reported incidence, which ranged from 0.67/100,000/year in Taiwan to 3.67/100,00/year in Australia. CONCLUSIONS: This comprehensive study provides an update of MS epidemiology in Africa, Asia, Australia, and New Zealand. Incidence and prevalence were lowest in Africa and Asia and highest in Australia, but many Asian studies were of poor quality. Use of consistent case ascertainment methods, standardized data collection tools, and similar outcomes would all improve study quality and comparability. The underlying basis of observed ethnic differences is an important area for future study.
OBJECTIVES: Studies of multiple sclerosis (MS) incidence and prevalence from Africa, Asia, Australia and New Zealand are relatively scarce. We systematically reviewed MS incidence and prevalence in these regions including a standardized evaluation of study quality. METHODS: We searched MEDLINE and EMBASE databases for studies of MS prevalence or incidence in Africa, Asia, Australia and New Zealand published in English or French between January 1, 1985 and January 31, 2011. Study quality was assessed using a standardized tool. All steps of the review were performed in duplicate. RESULTS: Of 3925 citations identified, 28 studies met inclusion criteria and 21 of these were from Asia. Quality scores ranged from 1/8 to 8/8; the lowest scores were observed in studies from Asia (median 4/8, IQR 3,6). Prevalence was lowest in South African Blacks (0.22/100,000) and highest amongst Australian-born individuals in Australia (125/100,000). Prevalence increased over time in many countries. MS prevalence increased with increasing latitude only in some regions, and prevalence varied significantly with ethnicity. Eight studies reported incidence, which ranged from 0.67/100,000/year in Taiwan to 3.67/100,00/year in Australia. CONCLUSIONS: This comprehensive study provides an update of MS epidemiology in Africa, Asia, Australia, and New Zealand. Incidence and prevalence were lowest in Africa and Asia and highest in Australia, but many Asian studies were of poor quality. Use of consistent case ascertainment methods, standardized data collection tools, and similar outcomes would all improve study quality and comparability. The underlying basis of observed ethnic differences is an important area for future study.
Authors: Elaine Kingwell; Feng Zhu; Ruth Ann Marrie; John D Fisk; Christina Wolfson; Sharon Warren; Joanne Profetto-McGrath; Lawrence W Svenson; Nathalie Jette; Virender Bhan; B Nancy Yu; Lawrence Elliott; Helen Tremlett Journal: J Neurol Date: 2015-07-24 Impact factor: 4.849
Authors: William J Culpepper; Ruth Ann Marrie; Annette Langer-Gould; Mitchell T Wallin; Jonathan D Campbell; Lorene M Nelson; Wendy E Kaye; Laurie Wagner; Helen Tremlett; Lie H Chen; Stella Leung; Charity Evans; Shenzhen Yao; Nicholas G LaRocca Journal: Neurology Date: 2019-02-15 Impact factor: 9.910