Rising Prevalence of Multiple Sclerosis in Saudi Arabia, a Descriptive Study

Abstract

Introduction In 2015, the first nationwide, multi-center MS registry was initiated in Saudi Arabia mainly with an objective to describe current epidemiology, disease patterns, and clinical characteristics of MS in Saudi Arabia. This article aimed to report initial findings of the registry and regional prevalence of MS. Method The registry included patients with confirmed MS diagnosis according to the 2010 McDonald Criteria. It aimed to identify and recruit all healthcare facilities treating MS patients in the Kingdom, and collect data such as demographics, clinical characteristics, family history, and treatments. All included sites have obtained IRB/EC approvals for participating in the registry. Currently, the registry includes 20 hospitals from different regions across the Kingdom. The Projected prevalence was calculated based on the assumption that the number of diagnosed MS cases in participating hospitals (in each region) is similar to the number of cases in remaining nonparticipant hospitals in the same region. Results As of September 2018, the registry has included 20 hospitals and has collected comprehensive data on 2,516 patients from those hospitals, with median age 32(Range: 11-63) and 66.5% being females. The reported prevalence of MS for those hospitals was estimated to be 7.70/100,000 population and 11.80/100,000 Saudi nationals. Based on the assumption made earlier, we projected the overall prevalence of MS at the country level to be 40.40/100,000 population and 61.95/100,000 Saudi nationals. 77.5% were 40 years of age or younger. The prevalence was higher among females, young and educated individuals across all five regions of Saudi Arabia Conclusion The prevalence of MS has significantly increased in Saudi Arabia but is still much lower than that in the western and other neighboring countries like Kuwait, Qatar, and the UAE. However, compared to the past rates, Saudi Arabia’s projected prevalence of MS through this national study is 40.40/100,000 population, putting them above the low risk zone as per Kurtzke classification. The projected prevalence was estimated to be much higher among Saudi nationals (61.95/100,000 Saudi-nationals). The prevalence was higher among female, younger and educated individuals. Further studies are needed to assess the risk factors associated with increased prevalence in Saudi Arabia.

Risk factors of multiple sclerosis in Aseer region, Kingdom of Saudi Arabia A case-control study

“…Studies from around the globe have reported a female preponderance of MS. 26,27 The gender gradient in this study is confirmed from the Saudi registry of MS, which has established a 2:1 female:male ratio of MS in the country. 28 This difference could be explained by inherent differences in genetics and in physiological responses to other proposed risk factors, such as environmental and medical risk factors. It has also been proposed that the female preponderance of MS could be related to changes in environmental interactions rather than genetic factors.…”

Familial aggregation of multiple sclerosis: Results from the national registry of the disease in Saudi Arabia

“… 10 According to the 2013 MS Atlas, 11 Middle Eastern and North African countries are located in a low- to moderate-risk zone for MS; however, recent studies have reported increased prevalence in these countries especially among women. 12 – 16 This increased prevalence, not only imposes a huge burden on the healthcare systems, but also negatively affects the quality of life of impacted patients and their families. Thus, it is important to study the multiple domains and underlying risk factors that are associated with the rising prevalence of MS, and that in turn could benefit the healthcare planning and policymaking.…”

An Overview of Genome-Wide Association Studies in Multiple Sclerosis

“…The Gulf area was historically considered to have a low MS prevailing, but in recent years, data indicates a dramatic increase of prevalence rates of 31-55 MS per 100,0000 in the number of MS cases in general in the region, including Saudi Arabia [14]. No national or regional registers in the country are still available to explain the actual disease burden and obtain precise estimates [108]. According to few reports, the Gulf region's increased prevalence may be attributed to lifestyle changes, vitamin D deficiencies and parental consanguinity [13,109].…”