![]() Scores of very low, low, moderate or high are shown in shades of orange and red as per the key. (b) Confidence score assigned to each country based on the prevalence data sources provided. ![]() Countries without prevalence data are shown in grey. Map showing geographic variation in MS prevalence and in data confidence scores a by country: (a) MS prevalence per 100,000 population by country shown in shades of orange and red as per the key. Sub-region rates were applied to countries with missing data using their 2019 populations. Finally, missing data were imputed for the global prevalence calculation by using available prevalence data to calculate pooled prevalence rates for 15 geographic sub-regions based on the Global Health Data Exchange. Third, a literature review was conducted to identify prevalence estimates for missing countries and query outliers. Countries were given a confidence rating for prevalence, incidence, age of MS onset and type of MS at onset based on the confidence scores of their reported data sources. Second, all data sources reported were scored using a confidence tool based on the proportion of the country’s population included, year and method of data collection, MS diagnostic criteria used and peer-review or other validation efforts (see Figure 1). First, key terms in the survey were explicitly defined. In this edition, several methodological changes were made to improve data quality. Coordinators also reported their data sources which potentially included publications and presentations, registries, government/health system statistics, administrative data sets, electronic medical records and opinions of experts (typically neurologists, researchers, or MS societies). Consistent with previous editions of the Atlas, country coordinators reported the incidence and prevalence of MS in adults and children, separately for males and females diagnostic criteria employed in their country and key clinical characteristics such as age and MS type at diagnosis. 3 Herein, we discuss the approach to epidemiologic data collection from the third edition of the Atlas, 4 including methodological improvements, key findings and future directions.ĭevelopment of the Atlas of MS, third editionīetween September 2019 and March 2020, MSIF collected epidemiologic data from 115 countries representing 87% of the world’s population. The first edition was produced in 2008 in collaboration with the World Health Organization (WHO) and it was updated in 2013. Thus, there is a continued, compelling need for high-quality epidemiologic data worldwide to improve our understanding of disease risk, support health policy aimed at meeting the diverse needs of people with MS and support advocacy efforts.Ĭompiled by the Multiple Sclerosis International Federation (MSIF), the Atlas of MS ( is an open-source global compendium of data regarding the epidemiology of MS, and the availability of resources for people with MS reported at country, regional and global levels. The growing arsenal of disease-modifying therapies offers opportunities to reduce disability 1 and extend survival 2 of people with MS however, a cure is still lacking and the etiology of the disease remains incompletely understood. Multiple sclerosis (MS) usually presents at a highly productive stage of life when people are planning families and building careers and as such MS can have a significant impact on affected individuals, their families and society.
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