Prevalence of multiple sclerosis in Guangzhou, China: A population-based case-finding prospective study

Multiple sclerosis (MS) is a lifelong, disabling and severe autoimmune disease, and it is a leading cause of nontraumatic disability in young people (Feinstein et al., 2014; Jongen et al., 2012; Kalb et al., 2019; Maguire and Maguire, 2020; Topcu et al., 2020). Accurate estimates of MS prevalence are essential for reducing the burden of disease and developing appropriate health care policies, which could help to improve the clinical accessibility to MS therapeutics and ultimately benefit patients (Bebo et al., 2022). Several studies have been reported on the prevalence of MS in some regions of China, such as Shanghai, Shandong, Taiwan, and Hong Kong, with estimated prevalence of 1.39, 5.20, 6.69, and 4.80, respectively (Cheng et al., 2007; Fang et al., 2020; Lau et al., 2008; Liu et al., 2016). Their studies used diagnostic criteria such as Poser (1983) and McDonald (2001), and were conducted by retrospectively surveying medical databases or establishing regional physician network to conduct the survey. However, differences in diagnostic criteria and survey methods can lead to wide variation in prevalence of MS, these studies may have overestimated the prevalence. As the diagnostic criteria for MS are constantly being revised and improved, the earlier Poser diagnostic criteria have been gradually replaced. Moreover, other inflammatory disorders of the central nervous system (CNS), such as neuromyelitis optica spectrum disorder (NMOSD), were also classified as optic spinal MS in earlier studies, leading to an overestimation of the prevalence of MS (Kira, 2003; Lennon et al., 2004). Therefore, there is a great need to investigate the prevalence of MS in China using the latest criteria.

Guangzhou is a mega-city in South China and one of the first cities to allow the cost of MS drugs to be reimbursed by medical insurance, but there are no relevant studies on the prevalence of MS in the region. In this study, we investigated the prevalence of MS in Guangzhou, China, by using a case-finding and face-to-face interview survey method. We also summarized the characteristics of patients with MS, including demographic characteristics, lifestyle, disease history, and clinical characteristics.

This study used data records from the Guangzhou health insurance system to recall MS patients by a case-finding method, and performed a face-to-face review according to criteria, with the aim of minimizing missed or misdiagnosis, which would accurately report the prevalence and provide a reference for clinical diagnosis and treatment.

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