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. 2018 Jun 8:9:432.
doi: 10.3389/fneur.2018.00432. eCollection 2018.

Multiple Sclerosis in the Asia Pacific Region: A Systematic Review of a Neglected Neurological Disease

Wing L Cheong  1 , Devi Mohan  2 , Narelle Warren  3 , Daniel D Reidpath  2
Affiliations

Multiple Sclerosis in the Asia Pacific Region: A Systematic Review of a Neglected Neurological Disease

Wing L Cheong et al. Front Neurol. .

Abstract

Background: Multiple sclerosis is thought to be relatively uncommon in the Asia Pacific region with prevalence estimated between 0 and 20 per 100,000. There is reason to doubt these estimates due to the lack of data from many countries and the growing evidence of variability in prevalence across small geographic areas. This study was conducted to systematically review the population prevalence, incidence, mortality and disability progression estimates of MS within the Asia Pacific region. Methods: The systematic review was conducted on articles from 1985 till 31st July 2017 within the PubMed/MEDLINE, EMBASE, SCOPUS, and The Cochrane Library databases. The review included articles that were population-based studies conducted on patients with MS in the Asia Pacific region that reported either incidence, prevalence, mortality, or disease progression. Hospital-based studies and non-research articles were excluded to ensure that only information representative of the population was included for analysis. Data appraisal and extraction was done by independent reviewers. This review was registered with PROSPERO (ID: CRD42017082760). Findings: Of the 2,757 articles found, 16 studies were included. Information on 6 (18.75%) of 32 Asia Pacific countries was found, with data representing 8% of the total population. Prevalence estimates were available for 6 countries while estimates for incidence (3 countries), mortality (4 countries), and disease progression (2 countries) were limited. Interpretation: The lack of epidemiological data available in the Asia Pacific region creates a blind spot in the surveillance of MS which obscures the true burden of MS, causing patients to struggle to receive the resources and funding that they need.

Keywords: Asia Pacific; disability; epidemiology; incidence; mortality; multiple sclerosis; prevalence; registries.

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Figures

Figure 1
Figure 1
Article selection process of systematic review.
Figure 2
Figure 2
Estimates of multiple sclerosis prevalence from the articles reviewed. Bars represent reported 95% confidence intervals.
Figure 3
Figure 3
Geographical areas with existing published estimates on MS epidemiology.
See this image and copyright information in PMC

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