Future of Management of Multiple Sclerosis in the Middle East: A Consensus View from Specialists in Ten Countries

Aljumah, Mohammed; Alroughani, Raed; Alsharoqi, I.; Bohlega, Saeed; Dahdaleh, Maurice; Deleu, Dirk; Esmat, Khaled; Khalifa, Ahmad; Sahraian, Mohammad Ali; Szólics, Miklós; AlTahan, Abdulrahman; Yamout, Bassem; Rieckmann, Peter; Daif, Abdulkader

doi:10.1155/2013/952321

Cited by 18 publications

(23 citation statements)

References 30 publications

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“…A similar increase has also been recorded in regions previously considered at low-risk for MS, like Middle-East [18][19][20] and South and East Asia [21]. This worldwide trend seems not to be related to the increased survival of MS patients due to more effective treatments, better management of symptoms and comorbidities, and/or to an earlier diagnosis of MS. As a matter of fact, the slopes of MS incidence and prevalence have significantly changed in the second part of the 20th century strongly pointing out the role of exogenous/environmental agents in determining the risk of MS. Interestingly, the mortality rate did not significantly change over the last 3 decades.…”

Section: Discussionsupporting

confidence: 71%

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

et al. 2018

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Background: Previous studies, dating back to the 1960s disclosed a progressive increase in multiple sclerosis (MS) incidence and prevalence in the Province of Padua. To further analyze whether this trend is the effect of the improved diagnostic procedures or is primarily related to a real increase risk of MS, we analyzed MS incidence and prevalence of the 5-year period 2011–2015. Methods: Patients with a diagnosis of MS or clinically isolated syndrome highly suggestive of MS were included in the study. All available sources of clinical and administrative information were evaluated. Mean annual incidence in the 5-year period 2011–2015 and the prevalence on December 31, 2015 were calculated. Results: The 2011–2015 mean incidence was 6.5/100,000/year, 7.9 for females, 4.1 for males. The overall prevalence was 182/100,000, 241 for females, 116 for males. Compared to the 2000–2009 period, mean age at onset, onset-diagnosis delay and F/M ratio did not significantly change. Since the 1960s, incidence and prevalence of MS linearly increased with no interposed plateau periods. Conclusions: MS incidence and prevalence further and significantly increased in the period 2011–2015. Our 1965–2015 data indicate a real increased risk of MS and stress a role of exogenous factors in MS susceptibility.

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Section: Discussionsupporting

confidence: 71%

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

et al. 2018

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“…Employers do not understand that patients with MS may require more sick leaves than others or need more time to accomplish certain tasks. In this regard, and as the number of MS patients is increasing in Jordan (Aljumah et al, ), we believe that there is a need for support systems and services that enable people with MS to continue employment as long as they are productive and have desire to work. Income security programs that are comprehensive and flexible enough to allow persons with episodic, recurring illnesses to work whenever possible without losing access to income support when ill and unemployed are needed.…”

Section: Discussionmentioning

confidence: 99%

“…Employers do not understand that patients with MS may require more sick leaves than others or need more time to accomplish certain tasks. In this regard, and as the number of MS patients is increasing in Jordan (Aljumah et al, 2013) (Bergen, 2002;World Health Organization, 2004). Furthermore, based on a survey by WHO, the number of nurses for MS in the world ranged from 0 to 0.07 per 100,000.…”

Section: Lack Of Awareness About Ms Rehabilitationmentioning

confidence: 99%

Living with multiple sclerosis: A Jordanian perspective

Al‐Sharman

Khalil

Nazzal

et al. 2018

Physiotherapy Res Intl

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Background Multiple sclerosis (MS) symptoms are very heterogeneous and may lead to reduced physical, cognitive, and psychosocial functioning that can consequently impair aspects of individual's life. Many studies have examined the living experiences of individuals with MS and its impact on their daily lives. In developing countries and particularly in Jordan, there has been little attempt to conduct studies exploring the experiences of people living with MS. Such knowledge will provide a background to hidden aspects of human concepts, such as culture, perception, and attitudes about chronic diseases. Objective The purpose of this qualitative study was to explore and describe the daily living experiences and challenges of Jordanian individuals with MS. Methods A qualitative design was utilized. Sixteen individuals with MS took part in the study; they were interviewed and divided into 4 focus groups. Conversations were digitally recorded followed by a verbatim transcription. Transcripts were analysed using thematic analysis and validated via researcher triangulation and peer checking. Results Experiences of 16 Jordanian individuals with MS who participated in this study were categorized into the following major themes: (a) experiences related to the disease itself and (b) experiences related to the healthcare system. Disease‐related experiences include physical decline, psychosocial withdrawal, and fear of the future. Participants' experiences with the healthcare system include difficulty of diagnosis, poor communication and rapport with healthcare providers, and lack of awareness about MS and its rehabilitation. Conclusions Findings of this study suggests that more attention should be given to the people with MS in Jordan. In particular, awareness about the disease should be improved among healthcare providers and the general public. Furthermore, rehabilitation services should be emphasized during the management of MS disease.

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“…The recently reported increased prevalence of MS in the Middle East (6), the Gulf region (7,8) and in Bahrain (Alsharoqi et al, 2014, unpublished data, where prevalence was found to be 50/100,1000) has stimulated the study of differential gene expression in Bahraini MS patients with an insight to detect novel genes that may correlate with the pathogenesis of MS.…”

Section: Discussionmentioning

confidence: 99%

“…There is a universal increase in the prevalence and incidence of MS over time. In the Middle East, and particularly the Gulf region, an increased prevalence has been recently reported (6)(7)(8) due to genetic and environmental factors, particularly following the most recent wars in the region (9), with a similar increase in Bahrain (Alsharoqi et al, 2014, unpublished data).…”

Section: Introductionmentioning

confidence: 97%

Differential upregulation of the hypothetical transmembrane protein 66 (TMEM66) in multiple sclerosis patients with potential inflammatory response

et al. 2014

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Abstract. The prevalence of multiple sclerosis (MS) in the Gulf region has markedly increased during the last decade, but the mechanisms of the disease have not been investigated. The present study aimed to understand the molecular processes involved in the disease development of the recently emerged MS in this population using microarray technology to investigate differentially-expressed novel genes in MS patients compared to healthy-matched subjects. The expression of the upregulated genes was confirmed by quantitative polymerase chain reaction (qPCR). Furthermore, gene cloning, protein expression and purification were performed followed by testing of the obtained recombinant protein on biological assays, including cell proliferation and cytokine mRNA detection by reverse transcriptase-qPCR. The results showed that out of ~50,000 genes, the hypothetical transmembrane protein-66 gene (TMEM66) exhibited a 3 times higher expression in MS patients compared to healthy subjects. The TMEM66 gene was cloned and its protein showed marked immunological activity relevant to MS since significant proliferation (P<0.05) and augmented induction of the proinflammatory cytokines, interleukin (IL)-6, interferon-γ, tumor necrosis factor-α, and the chemokines, chemokine ligand 5/chemokine receptor 5, macrophage inflammatory protein 1α (MIP-1α) and MIP-1β were recorded, but not the anti-inflammatory cytokines, IL-4 or IL-2. In conclusion, TMEM66 may be associated with the molecular events of MS and may be considered as an MS biomarker for future personalized medicine management approaches.

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Future of Management of Multiple Sclerosis in the Middle East: A Consensus View from Specialists in Ten Countries

Cited by 18 publications

References 30 publications

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

Living with multiple sclerosis: A Jordanian perspective

Differential upregulation of the hypothetical transmembrane protein 66 (TMEM66) in multiple sclerosis patients with potential inflammatory response

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