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Prevalence and disease disability in immigrants with multiple sclerosis in Malmö, southern Sweden

Alonso-Magdalena, Lucía LU ; Carmona i Codina, Olga LU ; Zia, Elisabet LU ; Sundström, Peter and Pessah-Rasmussen, Hélène LU (2024) In Clinical Neurology and Neurosurgery 240.
Abstract

Background: Multiple sclerosis (MS) is the most common chronic demyelinating disease of the central nervous system and the major non-traumatic cause of permanent disability in young adults. Several migration studies have been performed over the years suggesting a pattern of higher disease disability in certain ethnic groups. To our knowledge, differences in disease progression in immigrants have not been studied in Sweden before. Thus, the aims of our study were to estimate the prevalence of multiple sclerosis among first-generation immigrants in the City of Malmö and to compare differences in disease severity with the native population. Methods: All persons with multiple sclerosis living in Malmö on prevalence day 31 Dec 2010 were... (More)

Background: Multiple sclerosis (MS) is the most common chronic demyelinating disease of the central nervous system and the major non-traumatic cause of permanent disability in young adults. Several migration studies have been performed over the years suggesting a pattern of higher disease disability in certain ethnic groups. To our knowledge, differences in disease progression in immigrants have not been studied in Sweden before. Thus, the aims of our study were to estimate the prevalence of multiple sclerosis among first-generation immigrants in the City of Malmö and to compare differences in disease severity with the native population. Methods: All persons with multiple sclerosis living in Malmö on prevalence day 31 Dec 2010 were included. Cases were classified according to the country of birth into Scandinavians, Western and non-Western. Results: The crude prevalence was 100/100,000 (95% CI, 80–124) among first-generation immigrants, 154/100,000 (95% CI, 137–173) among individuals with Scandinavian background, 123/100,000 (95% CI, 94–162) in the Western group and 76/100,000 (95% CI, 53–108) in the non-Western group. The mean Multiple Sclerosis Severity Score (MSSS) value among Scandinavians was 4.2 (SD 3.5), whereas the figures in the immigrant group were 4.6 (SD 3.3) and 5.2 (SD 3.7) among Westerns respectively non-Westerns, which differences were not statistically significant. When adjusting for gender, age at onset and initial disease course, the mean MSSS difference between the non-Western and the Scandinavian individuals was 1.7 (95% CI 0.18–3.3, p = 0.030). There were no differences on time to diagnosis or the time from diagnosis to treatment initiation between the three groups. Conclusions: We found a lower prevalence among Western and non-Western first-generation immigrants compared to the Scandinavian population and a more severe disease in non-Western immigrants than in Scandinavians.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Disability, Epidemiology, Immigrant, Multiple sclerosis, Prevalence, Sweden
in
Clinical Neurology and Neurosurgery
volume
240
article number
108255
publisher
Elsevier
external identifiers
  • scopus:85189085813
  • pmid:38552363
ISSN
0303-8467
DOI
10.1016/j.clineuro.2024.108255
language
English
LU publication?
yes
id
84975b11-07ac-44c0-b047-d917692f86e4
date added to LUP
2024-04-22 13:32:04
date last changed
2024-06-17 18:29:20
@article{84975b11-07ac-44c0-b047-d917692f86e4,
  abstract     = {{<p>Background: Multiple sclerosis (MS) is the most common chronic demyelinating disease of the central nervous system and the major non-traumatic cause of permanent disability in young adults. Several migration studies have been performed over the years suggesting a pattern of higher disease disability in certain ethnic groups. To our knowledge, differences in disease progression in immigrants have not been studied in Sweden before. Thus, the aims of our study were to estimate the prevalence of multiple sclerosis among first-generation immigrants in the City of Malmö and to compare differences in disease severity with the native population. Methods: All persons with multiple sclerosis living in Malmö on prevalence day 31 Dec 2010 were included. Cases were classified according to the country of birth into Scandinavians, Western and non-Western. Results: The crude prevalence was 100/100,000 (95% CI, 80–124) among first-generation immigrants, 154/100,000 (95% CI, 137–173) among individuals with Scandinavian background, 123/100,000 (95% CI, 94–162) in the Western group and 76/100,000 (95% CI, 53–108) in the non-Western group. The mean Multiple Sclerosis Severity Score (MSSS) value among Scandinavians was 4.2 (SD 3.5), whereas the figures in the immigrant group were 4.6 (SD 3.3) and 5.2 (SD 3.7) among Westerns respectively non-Westerns, which differences were not statistically significant. When adjusting for gender, age at onset and initial disease course, the mean MSSS difference between the non-Western and the Scandinavian individuals was 1.7 (95% CI 0.18–3.3, p = 0.030). There were no differences on time to diagnosis or the time from diagnosis to treatment initiation between the three groups. Conclusions: We found a lower prevalence among Western and non-Western first-generation immigrants compared to the Scandinavian population and a more severe disease in non-Western immigrants than in Scandinavians.</p>}},
  author       = {{Alonso-Magdalena, Lucía and Carmona i Codina, Olga and Zia, Elisabet and Sundström, Peter and Pessah-Rasmussen, Hélène}},
  issn         = {{0303-8467}},
  keywords     = {{Disability; Epidemiology; Immigrant; Multiple sclerosis; Prevalence; Sweden}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Neurology and Neurosurgery}},
  title        = {{Prevalence and disease disability in immigrants with multiple sclerosis in Malmö, southern Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.clineuro.2024.108255}},
  doi          = {{10.1016/j.clineuro.2024.108255}},
  volume       = {{240}},
  year         = {{2024}},
}