Department of Functional Neurosurgery Medical School, Isfahan University of Medical Science, Isfahan, Iran.
Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran.
Mult Scler Relat Disord. 2020 May;40:101959. doi: 10.1016/j.msard.2020.101959. Epub 2020 Jan 21.
There is an unapprehended diversity in the epidemiology of multiple sclerosis (MS) in different geographical regions. In this study, for the first time, we systematically review the studies estimating the incidence and/or prevalence of MS in the Persian Gulf area. The goal is to obtain the overall incidence and prevalence of MS and elucidate the reasons for the geographical variation.
A comprehensive literature search was carried out using MEDLINE and EMBASE through articles published between January 1985 and December 2018 on MS epidemiology in Persian Gulf countries including Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Search terms included 'Multiple sclerosis', 'Incidence', 'Prevalence', 'Epidemiology', 'Persian Gulf', 'Arabian Gulf' and name of each country. Only full-text articles published in English were included. All abstracts were considered and two trained reviewers evaluated the study quality using an assessment tool specifically designed for this study.
39 studies met the inclusion criteria. The mean age at disease onset varied in each country and the pooled mean age of onset was 23.11. The overall pooled MS incidence was 5.03/100,000 person-years (95% CI: 0.04 - 10.02). Prevalence was 39.31/100,000 (95% CI: 29.12 - 49.50) and the result of the meta-regression method showed that prevalence increased by 2.3% per year between 1985-2018 (p = 0.04). Quality scores ranged from 4/7 to 8/8.
The prevalence and incidence of MS in the Persian Gulf region has gone through significant changes during the past decades. This study highlights the need for future studies of MS prevalence and incidence, which will further elucidate the possible etiologies leading to periodical and geographical variations in MS incidence.
多发性硬化症（MS）在不同地理区域的流行病学存在未被理解的多样性。在这项研究中，我们首次系统地回顾了评估波斯湾地区 MS 发病率和/或患病率的研究。目的是获得 MS 的总体发病率和患病率，并阐明地理变异的原因。
使用 MEDLINE 和 EMBASE 进行全面的文献检索，检索了 1985 年 1 月至 2018 年 12 月间发表的关于波斯湾国家（包括巴林、伊朗、伊拉克、科威特、阿曼、卡塔尔、沙特阿拉伯和阿拉伯联合酋长国）MS 流行病学的文章。搜索词包括“多发性硬化症”、“发病率”、“患病率”、“流行病学”、“波斯湾”、“阿拉伯湾”和每个国家的名称。仅纳入全文发表在英语的文章。考虑了所有的摘要，并且两名经过培训的评审员使用专门为此研究设计的评估工具评估了研究质量。
39 项研究符合纳入标准。每个国家的疾病发病年龄不同，发病年龄的 pooled 平均值为 23.11。总的 MS 发病率为 5.03/100,000 人年（95%CI：0.04-10.02）。患病率为 39.31/100,000（95%CI：29.12-49.50），meta 回归方法的结果表明，1985 年至 2018 年间患病率每年增加 2.3%（p=0.04）。质量评分范围从 4/7 到 8/8。
在过去几十年中，波斯湾地区的 MS 患病率和发病率发生了显著变化。本研究强调了未来 MS 患病率和发病率研究的必要性，这将进一步阐明导致 MS 发病率周期性和地理性变化的可能病因。
