Highlights
- •We systematically reviewed MS incidence and prevalence in Africa, Asia, Australia, and New Zealand.
- •Highest prevalence was observed in Australian-born Australians and lowest prevalence was seen in South African Blacks.
- •Prevalence increased over time in many countries.
- •MS prevalence increased with increasing latitude only in some regions.
- •Prevalence varied significantly with ethnicity.
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.
Keywords
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Article info
Publication history
Published online: July 29, 2013
Accepted:
June 27,
2013
Received:
May 10,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
