Multiple sclerosis epidemiology in Latin America: An updated survey

Cristiano, Edgardo; Rojas, Juan Ignacio

doi:10.1177/2055217317715050

Cited by 22 publications

(31 citation statements)

References 54 publications

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“…This overall increase could be partially explained by female incidence estimates rising from 8.4/100,000 in 2013 to 9.8/100,000 in 2016, while male incidence has remained somewhat more stable, around 3.7/100,000, during that same time period. Nevertheless, a slight incidence increase over time has also been reported in Argentina and Panama in a recent update on MS in Latin America [16]. Reviewing the only 3 MS incidence studies in the Caribbean and Latin America, the authors also found an increase in MS incidence in Panama over a 16-year period (1990–1999 and 2000–2005) from 0.3/100,000 to 0.5/100,000 (Gracia et al [10]) and in Buenos Aires, Argentina from 1.8/100,000 in 2010 [17] to 3.0/100,000 in 2016 [18].…”

Section: Discussionmentioning

confidence: 99%

“…The estimated 2016 cumulative prevalence of MS in PR is the highest among countries in the Caribbean and Latin America [16]. Prevalence estimates in this region ranges from a low of 0.75/100,000 in Guayaquil, Ecuador [32] to a high of 38.2/100,000 in Buenos Aires, Argentina [18].…”

Section: Discussionmentioning

confidence: 99%

“…The other methodological difference is the size of the population studied and consequently the number of new MS cases. Incidence estimates from Martinique, Guadalupe, and Buenos Aires are based on the examination of populations with less than 400,000 people [16]. Consequently, the annual number of newly diagnosed MS cases was small (12–42 new cases) when compared with the 583 new cases (2013–2016) from 2.2 million adults in PR.…”

Section: Discussionmentioning

confidence: 99%

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Increasing Incidence and Prevalence of Multiple Sclerosis in Puerto Rico (2013–2016)

et al. 2017

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Background: The incidence of multiple sclerosis (MS) has been increasing worldwide over the past decades. However, this upward trend has not been examined at the country level in Latin America and the Caribbean (LAC). The aims of this study are to examine trends of MS incidence over 4 years and to provide age- and gender-standardized incidence rate estimates for a Caribbean island. Methods: Data from the Puerto Rico (PR) MS Foundation’s registry was used to identify all newly diagnosed MS cases between 2013 and 2016. MS patients were 18 years and older and met the 2010 revised McDonald criteria. Age- and gender-standardized incidence rates were estimated. Results: A total of 583 new MS cases were diagnosed in PR from 2013 to 2016. The age- and gender-standardized MS incidence rate for PR increased from 6.1/100,000 in 2013 to 6.7/100,000 in 2016. The annual age-standardized MS incidence rates for females rose from 8.4/100,000 in 2013 to 9.8/100,000 in 2016 and were higher than males, which remained around 3.7/100,000. Conclusion: Incidence estimates for PR were higher than other LAC countries but consistent with MS increases in other world regions. Our findings tend to rule out several prior potential environmental explanations for high MS incidence rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Increasing Incidence and Prevalence of Multiple Sclerosis in Puerto Rico (2013–2016)

et al. 2017

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“…A recent systematic review published in 2017 estimates the epidemiological characteristics of MS in Latin America, based on the results available from seven countries . This study shows that the incidence of MS in Latin America fluctuates in the range of 0.15 to 3 annual cases per 100 000 person‐years . Likewise, the estimated prevalence was in the range from 0.75 to 38.2 cases per 100 000 person‐years .…”

Section: Introductionmentioning

confidence: 75%

“…The aetiology of MS is unknown, but there are several hypotheses that account for epidemiological and environmental factors, such as infections and genetics . A recent systematic review published in 2017 estimates the epidemiological characteristics of MS in Latin America, based on the results available from seven countries . This study shows that the incidence of MS in Latin America fluctuates in the range of 0.15 to 3 annual cases per 100 000 person‐years .…”

Section: Introductionmentioning

confidence: 81%

Cost-effectiveness of interferon therapy for multiple sclerosis in Peru: impact of treatment adherence

Bolaños-Díaz

Sanabria

Custodio

2019

Journal of Pharmaceutical Health Services Research

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Objective To analyse the cost‐effectiveness (C‐E) of interferon therapy for MS and the impact of adherence associated with a patient support programme (PSP). Methods Markov model was structured based on systematic review of the evidence and the opinion of local experts. The model has three health states: (1) Baseline treatment (BT), (2) Interferon‐β (IFN) with patient support programme (PSP) and (3) IFN without PSP. Annual cycles were considered, with a time horizon of 30 years. The analysis perspective was based on the Ministry of Health (MoH). Key findings Interferon‐β + PSP dominates the treatment of IFN without PSP. The incremental C‐E rate (ICER) for IFN + PSP was estimated at S/. 26 408 per Quality Adjusted Life Year (QALY) in relation to BT. IFN without PSP was dominated by the IFN + PSP treatment. The cost per QALY of IFN + PSP was below the payment threshold in almost 100% of the model simulations. The acceptability curves show that the treatment with PSP + IFN is probabilistically more cost effective from a payment threshold of 1.25 annual Gross Domestic Product per capita (GDP‐pc). The Tornado analysis for the ICER between IFN + PSP and BT shows that the most sensitive variables of the model are the relative risk (RR) for treatment adherence and the cost of IFN + PSP treatment. Conclusion The addition of a PSP had a significant effect on adherence and C‐E of the intervention. The ICER for IFN + PSP was below 1.5 annual GDP‐pc of payment threshold with an incremental cost near to 3 GDP‐pc. IFN without PSP was dominated by the IFN + PSP.

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Population-Based Estimates for the Prevalence of Multiple Sclerosis in the United States by Race, Ethnicity, Age, Sex, and Geographic Region

et al. 2023

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ImportanceRacial, ethnic, and geographic differences in multiple sclerosis (MS) are important factors to assess when determining the disease burden and allocating health care resources.ObjectiveTo calculate the US prevalence of MS in Hispanic, non-Hispanic Black (hereafter referred to as Black), and non-Hispanic White individuals (hereafter referred to as White) stratified by age, sex, and region.Design, Setting, and ParticipantsA validated algorithm was applied to private, military, and public (Medicaid and Medicare) administrative health claims data sets to identify adult cases of MS between 2008 and 2010. Data analysis took place between 2019 and 2022. The 3-year cumulative prevalence overall was determined in each data set and stratified by age, sex, race, ethnicity, and geography. The insurance pools included 96 million persons from 2008 to 2010. Insurance and stratum-specific estimates were applied to the 2010 US Census data and the findings combined to calculate the 2010 prevalence of MS cumulated over 10 years. No exclusions were made if a person met the algorithm criteria.Main Outcomes and MeasurementsPrevalence of MS per 100 000 US adults stratified by demographic group and geography. The 95% CIs were approximated using a binomial distribution.ResultsA total of 744 781 persons 18 years and older were identified with MS with 564 426 cases (76%) in females and 180 355 (24%) in males. The median age group was 45 to 54 years, which included 229 216 individuals (31%), with 101 271 aged 18 to 24 years (14%), 158 997 aged 35 to 44 years (21%), 186 758 aged 55 to 64 years (25%), and 68 539 individuals (9%) who were 65 years or older. White individuals were the largest group, comprising 577 725 cases (77%), with 80 276 Black individuals (10%), 53 456 Hispanic individuals (7%), and 33 324 individuals (4%) in the non-Hispanic other category. The estimated 2010 prevalence of MS per 100 000 US adults cumulated over 10 years was 161.2 (95% CI, 159.8-162.5) for Hispanic individuals (regardless of race), 298.4 (95% CI, 296.4-300.5) for Black individuals, 374.8 (95% CI, 373.8-375.8) for White individuals, and 197.7 (95% CI, 195.6-199.9) for individuals from non-Hispanic other racial and ethnic groups. During the same time period, the female to male ratio was 2.9 overall. Age stratification in each of the racial and ethnic groups revealed the highest prevalence of MS in the 45- to 64-year-old age group, regardless of racial and ethnic classification. With each degree of latitude, MS prevalence increased by 16.3 cases per 100 000 (95% CI, 12.7-19.8; P &lt; .001) in the unadjusted prevalence estimates, and 11.7 cases per 100 000 (95% CI, 7.4-16.1; P &lt; .001) in the direct adjusted estimates. The association of latitude with prevalence was strongest in women, Black individuals, and older individuals.Conclusions and RelevanceThis study found that White individuals had the highest MS prevalence followed by Black individuals, individuals from other non-Hispanic racial and ethnic groups, and Hispanic individuals. Inconsistent racial and ethnic classifications created heterogeneity within groups. In the United States, MS affects diverse racial and ethnic groups. Prevalence of MS increases significantly and nonuniformly with latitude in the United States, even when adjusted for race, ethnicity, age, and sex. These findings are important for clinicians, researchers, and policy makers.

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Multiple sclerosis epidemiology in Latin America: An updated survey

Cited by 22 publications

References 54 publications

Increasing Incidence and Prevalence of Multiple Sclerosis in Puerto Rico (2013–2016)

Increasing Incidence and Prevalence of Multiple Sclerosis in Puerto Rico (2013–2016)

Cost-effectiveness of interferon therapy for multiple sclerosis in Peru: impact of treatment adherence

Population-Based Estimates for the Prevalence of Multiple Sclerosis in the United States by Race, Ethnicity, Age, Sex, and Geographic Region

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