According to study author Deanna Saylor, MD, MHS, of the Johns Hopkins University School of Medicine in Baltimore and a member of the American Academy of Neurology, the results suggest that the incidence of MS is greatly underestimated in low-income countries where healthcare costs are low. This suggests that there is a possibility that That means less access to a neurologist who has the expertise to diagnose her MS and MRI scanners needed for diagnosis.

For the analysis, the researchers analyzed data from scientific studies and databases to determine current MS rates in 203 countries and territories. grouped by.

Rates of multiple sclerosis vary by region and income level. For example, in high-income countries an average of 46 per 100,000 people had MS, whereas in low-income countries he was 10 per 100,000. In high-income countries, he spent $2,805 per person on health care, compared to $45 in low-income countries.

For each location, researchers measured gross domestic product per capita, current healthcare costs per capita, income level, availability of brain scans to diagnose multiple sclerosis, and neurologists per capita. and universal health care. They also reviewed lifestyle factors such as obesity and tobacco use.

When researchers adjusted the data for other factors that may influence MS risk, such as age and gender, they found that healthcare costs and latitude were strongly associated with MS incidence. The study showed that for every 1 standard deviation increase in per capita health care costs, the national MS prevalence increased by 0.49. Alternatively, for each standard deviation increase in latitude, the national MS prevalence increased by 0.65.

Researchers also found that medical costs explain some, but not all, of the relationship between latitude and multiple sclerosis. After adjusting for other factors, the relationship between latitude and MS decreased by more than 20% when considering per capita health care costs.

Availability of universal health care was associated with MS incidence in all regions of the world except Southeast Asia, and universal health care was associated with higher MS incidence.

In high-income countries, the incidence of MS was associated with most factors, including gross domestic product per capita, current health care spending per capita, and number of neurologists, but tobacco use and It was not associated with obesity, or the number of MRI units per person. But in low-income countries, there was no association with either of these factors, which could be explained by the lack of significant variation in data from these countries, Thaler said.

According to Thaler, the finding that current per capita health care costs are very strongly associated with the incidence of multiple sclerosis in the country means that as investment in health care increases, the reported incidence of multiple sclerosis increases. further supports the hypothesis that the She also found that minimal associations between multiple sclerosis incidence and lifestyle factors such as tobacco use and obesity suggest that lifestyle and consumption behavior may contribute to the reported incidence of multiple sclerosis. We argued that this is contrary to our previous assumption that it explains most of the regional differences.

Thaler said there is an urgent need for strategies to mitigate the shortage of trained professionals and critical skills that hinder accurate assessment of the burden of multiple sclerosis in low-income countries. She also noted that the low incidence of MS currently reported in these countries obscures the need for training of health care providers on MS and is thought to be the scarce resource most likely to occur. It also noted that investments to improve diagnosis and treatment in areas often targeted for diseases that have been diagnosed may be limited. General.

A limitation of this study is that different data sources may have collected information over different time periods or used different methods, which could affect the accuracy of the estimates.

This research was supported by the National Multiple Sclerosis Society. Apart from this research, Thaler is a recipient of the 2020 AAN Practical Research Training Scholarship funded by the American Academy of Neurology and co-editor of Without Borders. neurology Global Health Section.