THURSDAY, Aug. 25, 2022 (HealthDay News) — Exposure to vitamin D, or lack thereof, has long been thought to influence the risk of developing multiple sclerosis (MS), as the disease is diagnosed more often in people from the countries of the North.
However, new research suggests there may be an additional reason why there are fewer MS cases in the Global South: there are more undiagnosed cases there due to lower spending on MS. health.
With lower levels of healthcare spending, people may have less access to neurologists who have the expertise to diagnose MS and the MRI scans needed to make the diagnosis, said study author Dr. Deanna Saylor. She is from Johns Hopkins University School of Medicine in Baltimore and a Fellow of the American Academy of Neurology.
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Saylor and his colleagues analyzed data from studies and databases to determine current rates of MS in 203 countries and territories. They grouped countries into world regions and income levels.
They found that in high-income countries, an average of 46 out of 100,000 people had MS, compared to 10 out of 100,000 people in low-income countries. In high-income countries, per capita health expenditure was $2,805. It was significantly lower, at $45, in low-income countries.
The team also looked at gross domestic product per capita, current healthcare spending per capita, income levels, availability of brain scans to diagnose MS, number of neurologists per capita, and universal healthcare for everyone. some domains.
After adjusting for risk factors such as age and gender, they found that health care spending and latitude were strongly associated with MS rates.
For every one standard deviation increase in health expenditure per capita, the prevalence of MS in a country increased by 0.49. And for every one standard deviation increase in latitude, the prevalence of MS in a country increased by 0.65.
Health expenditure explained some, but not all, of the link between latitude and MS. When considering health expenditure per capita, the link between latitude and MS decreased by more than 20%.
The team found that the availability of universal health care was associated with higher rates of MS in all regions of the world except Southeast Asia.
The results were published on August 24 in the journal Neurology.
Greater investment in health care may lead to more robust reporting of MS rates, the researchers said.
In a press release, Saylor called for strategies to reduce shortages of skilled professionals and essential technologies in low-income countries. She noted that lower MS rates in these countries could mask the need for this investment.
The limitations of the study are that different data sources may have collected information during different time periods or with different methods, which may affect the accuracy of estimates.
The US National Institute of Neurological Disorders and Stroke has more on multiple sclerosis.
SOURCE: American Academy of Neurology, press release, August 24, 2022