2025 American Academy of Neurology Abstract Website

Syed Inam¹, Zain Nadeem², Mahad Butt², Hamza Ashraf², Eeshal Fatima³, Aimen Nadeem⁴, Haider Ashfaq², Ahmed Raza³, Sophia Ahmed², Madelyn Ross⁵
¹Marshall Neurology, ²Department of Medicine, Allama Iqbal Medical College, ³Department of Medicine, Services Institute of Medical Sciences, ⁴Department of Medicine, King Edward Medical University, ⁵Marshall University Joan C Edwards School of Medicine

Objective:

We aim to identify the trends in the incidence and prevalence of multiple sclerosis (MS) in Pakistan from 1990 to 2021, stratified by sex and provinces of Pakistan.

Background:

Multiple sclerosis (MS) is associated with high morbidity and mortality, but contemporary data regarding its distribution in Pakistan is not available.

Design/Methods:

We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to obtain age-standardized rates for incidence (ASIR) and prevalence (ASPR) of MS per 100,000 people in Pakistan, with the 95% uncertainty intervals (UIs). Joinpoint regression was used to calculate the annual percentage change (APC) and average APC (AAPC) in rates.

Results:

The ASIR of MS in Pakistan increased from 0.45 (0.37 to 0.54) per 100,000 in 1990 to 0.50 (0.42 to 0.59) per 100,000 in 2021 (AAPC: 0.38). Females showed higher ASIR than males both in 1990 (0.53 versus 0.37) and 2021 (0.60 versus 0.41) as well as a greater AAPC (0.36 versus 0.35). The highest AAPC in ASIR per 100,000 was observed in Islamabad Capital Territory (0.63) and the lowest in Gilgit Baltistan (0.29). The ASPR of MS in Pakistan increased from 8.34 (6.67 to 10.17) per 100,000 in 1990 to 9.80 (8.12 to 11.62) per 100,000 in 2021 (AAPC: 0.52). Females also showed a greater ASPR than males both in 1990 (10.56 versus 6.37) and 2021 (12.31 versus 7.38), with a greater AAPC (0.50 versus 0.48). The highest AAPC in ASPR per 100,000 was observed in Islamabad Capital Territory (0.84) and the lowest in Khyber Pakhtunkhwa (0.38).

Conclusions:

Our results indicate increasing incidence and prevalence of MS in Pakistan across both sexes and in all provinces, with the highest burden among females. Public awareness is an absolute necessity to control the rising trends of MS in a lower-middle income country like Pakistan.