MS in Pakistan

Researchers from Aga Khan University have just published data from the first in-depth study of multiple sclerosis in Pakistan. They enrolled 142 people with MS recruited from 5 centers across Pakistan, and found the following results:

• 81% had relapsing-remitting MS, with the majority of the remainder having primary-progressive MS
• The female-to-male ratio was 1.45:1
• Three-quarters of the participants were moderately or severely disabled
• Two-thirds of the patients with severe disability had a mean disease duration of only 5.2 years

The researchers concluded that MS is not uncommon in Pakistan. They specifically commented that the disease duration was short, given the level of disability.

However, I would point out, it must be kept in mind that disease duration is usually measured from time of diagnosis. Due to lack of MRI equipment in Pakistan it is likely that many, if not most, of these people were not diagnosed early in their disease. This explains not only the disability levels, given the short "duration of disease," but also the high percentage of primary-progressive MS. Many of the people with "primary-progressive MS" could simply be people that had undiagnosed relapsing-remitting MS until it turned into secondary-progressive MS, at which point it was simply diagnosed as primary-progressive MS.

I have not read the entire study, so perhaps some of the above points were mentioned.