Abstract Details

Title Incidence and Prevalence of MS in Indigenous Populations of the Americas: A systematic review

Topic Multiple Sclerosis

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-003

Background Recent changes in our understanding of incidence and prevalence have been observed for multiple sclerosis (MS) including increased recognition of underrepresented populations and health disparities. It is unclear if these changes include indigenous populations in the Americas who are more likely to be excluded in research and face health disadvantages.

Objective Systematic review of multiple sclerosis (MS) in Indigenous populations of the Americas.

Design/Methods PubMed, Web of Science, and Cochrane databases as well as references of retrieved papers were searched. Inclusion criteria were: peer reviewed publications (January 1990- November 2020), with incidence and prevalence rates, or severity outcomes of MS in self or tribe identified Indigenous individuals in the Americas. Studies were excluded if sample size or methodology of identifying populations was unclear. Incidence, prevalence, morbidity and mortality data were pooled through narrative review and grouped by location and year.

Results Only 12 studies met criteria. Studies reporting the outcomes if interest included incidence: 4, prevalence: 5, and severity outcomes: 5. All but one study were completed in Canada or the United States (US). Only two tribes were evaluated independently. Incidence rates ranged from 0.1/100k in Navajo People to 50.1/100k in a pooled US cohorts. Prevalence ranged from 0 in Lacandonian Mexicans to 188.5/100k in First Nations Manitoban Canadians. Higher latitudes and more recent studies reported higher incidence and prevalence. Compared to White populations, we found a lower incidence, prevalence, and mortality rates, but more motor involvement, more severe disability, or faster disability progression.

Conclusions Based on limited existing publications, incidence and prevalence rates are lower in Indigenous Peoples of the Americas compared to Whites, however disability may be worse. Indigenous Peoples have not typically been identified by individual tribe, and South and Central American populations have not been studied. Future studies in MS should include more robust data on Indigenous populations.

Authors/Disclosures
Michael V. Robers, MD (Barrow Neurological Institute) PRESENTER	Dr. Robers has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Robers has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. Robers has received research support from National Multiple Sclerosis Society. The institution of Dr. Robers has received research support from Bristol Myers Squibb Foundation. The institution of Dr. Robers has received research support from Barrow Neurological Foundation.
Brigitte F. Hurtubise, MD (Highland Hospital)	Dr. Hurtubise has nothing to disclose.
	No disclosure on file
Hollie K. Schmidt (Accelerated Cure Project)	Ms. Schmidt has received personal compensation for serving as an employee of Accelerated Cure Project for MS.
Lilyana M. Amezcua, MD, FAAN (USC)	Dr. Amezcua has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for serono. Dr. Amezcua has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Amezcua has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Amezcua has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for genentech. The institution of Dr. Amezcua has received research support from National MS Society. The institution of Dr. Amezcua has received research support from Genentech. The institution of Dr. Amezcua has received research support from Medday. The institution of Dr. Amezcua has received research support from Bristol Myers Squibb Foundation. The institution of Dr. Amezcua has received research support from NIH NINDS.
Brigitte F. Hurtubise, MD (Highland Hospital)	Dr. Hurtubise has nothing to disclose.