Burden of Multiple Sclerosis in Eastern Mediterranean Region (1990-2016): Findings From the 2016 Global Burden of Disease Study

Abstract

Background: Multiple sclerosis (MS) is among the leading causes of disability in Young Adults worldwide. Current estimates of MS burden in Eastern Mediterranean Region (EMR) are necessary for planning effective interventions .To estimate Prevalence, incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs) and disability-adjusted life-years (DALYs) in EMR by country age, and sex from 1990 to 2016 . Methods: We estimated regional and country-specific prevalence, incidence, mortality, DALYs, YLLs, and YLDs for MS. DALYs were computed as the sum of YLDs and YLLs.Results: Total DALYs in EMR countries was 12,810 in 1990 for males and increased to 36,391 in 2016 and from 18,962 to 53,851 for females. Lowest DALYs in both sexes were observed in Somalia (248) while the highest were in Iran (26,394). YLDs in males increased from 6,511 in 1990 to 19,515 in 2016, and in females from 12,247 to 33,937. The highest age-standardized prevalence, incidence, YLDs and DALYs were in Iran (72.11, 2.49, 18.03, and 32.5, respectively). Conclusions:Our findings provide valuable information to guide the development and implementation of measures to address the rising burden of MS and it consequences in the EMR countries.Disease (GBD) 2016 study to report MS burden in EMR countries to inform policy makers of the current and trend of MS burden. MethodsGBD 2016 covers 195 countries, 21 regions, and seven super-regions from 1990 to 2016 for 328 diseases and injuries, 2,982 sequelae, and 84 risk factors by age and sex. Detailed descriptions of GBD 2016 methodology and neurological disorders methodology have been provided elsewhere (DALYs and Collaborators, 2017; Disease et al.United Arab Emirates (UAE) and Yemen.All-cause mortality was first estimated for each country during the period of 1990-2016. For this purpose, we used all accessible data from vital registration systems, sibling history surveys, sample registration data, and household recall of deaths. We extracted causes of death data from the same sources, as well as available verbal autopsies, and then used GBD's Cause of Death Ensemble model to estimate the number of deaths from MS by age, sex, country, and year. In this approach, a large variety of possible models are explored to estimate trends in causes of death. Possible models are identified based on a covariate selection algorithm that yields several plausible combinations of covariates; they are then run through different model classes, including mixed effects linear models and spatiotemporal Gaussian process regression models for cause fractions and death rates. All models for each cause of death are then assessed using out-of-sample predictive validity and combined into an ensemble with optimal out-of-sample predictive performance (Mortality and Causes of Death, 2017).We updated our previous systematic reviews for the GBD study separately for each of the non-fatal sequelae of MS. Non-fatal burden estimates were based on a systematic review of the literature to obtain all available epidemiologica...

The prevalence of multiple sclerosis in Tehran, Iran, in 2020

“… 2 Iran had the highest prevalence of MS among the countries of the Eastern Mediterranean region (EMR) (72.11/100000). 3 …”

“…Among 22 EMR countries, the highest age prevalence rate (as 72.11 per 100000) and the highest age-standardized years lived with disability rate (as 18.03 per 100000) was estimated in Iran. 3 …”