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Prevalence of Multiple Sclerosis in Canada: A Systematic Review

Published online by Cambridge University Press:  02 December 2014

Alexandre Y. Poppe ,
Christina Wolfson  and
Bin Zhu
Alexandre Y. Poppe*
Affiliation:
Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, Alberta, Canada
Christina Wolfson
Affiliation:
Department of Epidemiology & Biostatistics, Department of Medicine, McGill University, Allan memorial Institute, Montreal, Quebec
Bin Zhu
Affiliation:
Department of Epidemiology & Biostatistics, Department of Medicine, McGill University, Allan memorial Institute, Montreal, Quebec
*
Department of Clinical Neurosciences, Foothills Medical Centre, 1403 29th Street, Calgary, Alberta, T2N 2T9, Canada.
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Abstract

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Background:

Studies of the prevalence of multiple sclerosis (MS) in Canada have generally been isolated to specific regions. Given the importance of multiple sclerosis as a cause of disability in adults, a comprehensive review of Canadian MS prevalence examining current data, interregional variation, deficiencies in knowledge and frontiers for research is timely.

Methods:

A systematic review of all studies addressing the prevalence of MS in Canada or regions within Canada, published in English or French since 1985, was conducted. Studies were identified using MEDLINE, EMBASE and bibliographic review. Ten studies were evaluated for methodological rigour and a test of heterogeneity across studies was performed and a measure of consistency (I2) estimated.

Results:

Studies were generally of high quality. Nine were restricted to regions within Canada and one provided an estimated national prevalence based on self-reported cases. All reported a high prevalence (>50 per 100 000). Latitude and longitude gradients were not striking while assessment of heterogeneity confirmed that regional differences were unlikely to be the result of sampling variability.

Conclusions:

This review confirms Canada as a country of very high MS prevalence and it is the first study to demonstrate that variation in regional estimates represents true differences in prevalence within Canada. Avenues for future MS prevalence research, including adoption of a national MS registry, are proposed.

Résumé:

RÉSUMÉ:Contexte:

Les études de prévalence de la sclérose en plaques (SEP) au Canada ont généralement porté sur des régions spécifiques du pays. Étant donné l'importance de la SEP comme cause d'invalidité chez les adultes, il est opportun de réviser la prévalence de la SEP au Canada en examinant les données actuelles, la variation interrégionale, les lacunes et les avenues de recherche.

Méthodes:

Nous avons révisé systématiquement toutes les études portant sur la prévalence globale ou régionale de la SEP au Canada, publiées en anglais ou en français depuis 1985. Nous avons utilisé MEDLINE, EMBASE et une revue bibliographique pour identifier les études. Nous avons évalué la rigueur méthodologique de dix études, ainsi que l'hétérogénéité entre les études et estimé la consistance interne des études.

Résultats:

Les études étaient généralement de bonne qualité. Neuf des études étaient des études régionales et une estimait la prévalence nationale à partir de cas autorapportés. Toutes ces études rapportaient une prévalence élevée (> 50 par 100 000). Un gradient de latitude ou de longitude n'était pas évident et l'évaluation de l'hétérogénéité a confirmé que des différences régionales n'étaient vraisemblablement pas le résultat de la variabilité de l'échantillonnage.

Conclusions:

Cette étude confirme que la prévalence de la SEP est très élevée au Canada. C'est la première étude à démontrer que la variation entre les estimations régionales représente des différences réelles dans la prévalence entre différentes régions du Canada. Nous proposons des avenues de recherche pour les études futures sur la prévalence de la SEP, dont la constitution d'un registre national de la SEP.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 5 , November 2008 , pp. 593 - 601
Copyright
Copyright © The Canadian Journal of Neurological 2008

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