Supplementary Material for: Multiple Sclerosis Epidemiology in Middle East and North Africa: A Systematic Review and Meta-Analysis

Background: Multiple sclerosis (MS) is one of the most common neurological disorders and a leading cause of nontraumatic disability in young adults in many countries. Recent reports from the Middle East and North Africa have suggested a moderate to high risk of MS in these countries. Methods: A literature search was performed in August 2014 in MEDLINE, EMBASE, and IMEMR to retrieve original population-based studies on MS epidemiology in the Middle East and North African countries published between 1st January 1985 and 1st August 2014. We designed search strategies using the key words: MS, prevalence, incidence, and epidemiology. According to the inclusion criteria, 52 studies were included in this systematic review. Results: McDonald's criteria were the most widely used diagnostic criteria in the studies. Most studies were conducted in single hospital-based centers with a defined catchment area. The female/male ratio ranged from 0.8 in Oman to 4.3 in Saudi Arabia. MS prevalence ranged from 14.77/100,000 population in Kuwait (2000) to 101.4/100,000 in Turkey (2006). The overall MS prevalence in the region was 51.52/100,000. The mean age at disease onset ranged from 25.2 years in Kuwait to 32.5 years in Northeastern Iran, with an overall estimate of 28.54 years. Conclusions: Recent advances in MS registries will allow nation-wide studies and temporal comparisons between countries, provided that age- and sex-standardized estimates are available.

背景：多发性硬化（Multiple Sclerosis, MS）是最为常见的神经系统疾病之一，亦是诸多国家青年群体非创伤性残疾的首要诱因。近期中东与北非地区的相关报告显示，该区域人群罹患多发性硬化的风险处于中至高水平。
研究方法：本研究于2014年8月针对MEDLINE、EMBASE及IMEMR数据库开展文献检索，旨在检索1985年1月1日至2014年8月1日期间发表的、关于中东与北非国家多发性硬化流行病学的原创基于人群的研究。本研究以MS、患病率、发病率及流行病学作为关键词构建检索策略。依据纳入标准，本系统综述最终纳入52项相关研究。
研究结果：纳入的研究中，麦克唐纳诊断标准（McDonald's criteria）为应用最广泛的多发性硬化诊断标准。多数研究依托具备明确就诊覆盖区域的单医院中心开展。男女患病比例范围为阿曼的0.8至沙特阿拉伯的4.3。多发性硬化患病率区间为科威特2000年报告的14.77/10万，至土耳其2006年报告的101.4/10万。该区域总体多发性硬化患病率为51.52/10万。疾病平均发病年龄区间为伊朗东北部的25.2岁至科威特的32.5岁，整体估算值为28.54岁。
研究结论：当前多发性硬化登记系统的最新进展，使得开展全国性研究以及多国间的时序对比成为可能，前提是需具备按年龄与性别标准化后的估算数据。