Amyotrophic Lateral Sclerosis in the Arab World: A Systematic Review and Meta-analysis
Abdullah Ashraf Hamad1, Ibraheem Alkhawaldeh2, Sondos Al-Abbadi2, Ahmed Mohamed Shahin1, Yasmin Negida3, Aya Elnaggar1
1Faculty of Medicine, Menoufia University, Menoufia, Egypt, 2Faculty of Medicine, Mutah University, Al-Karak, Jordan, 3Faculty of medicine Zagazig university, Zagazig, Egypt
Objective:
To summarize demographics, clinical features, healthcare context, and research trends of ALS in Arab countries.
Background:
ALS is a rapidly progressive neurodegenerative disorder affecting upper and lower motor neurons, leading to paralysis and death within a few years of onset. While global epidemiology and clinical patterns are well described, there is a paucity of region-specific data from Arab countries, which span diverse genetic, cultural, and healthcare contexts. Understanding regional characteristics is essential for tailoring diagnostic pathways, care delivery, and research priorities. Disparities in healthcare resources, delayed diagnosis, and limited multidisciplinary care may influence outcomes in these settings.
Design/Methods:
Following PRISMA guidelines, a literature search was conducted in March 2025 in PubMed, Scopus, and Web of Science. Inclusion criteria were observational studies reporting ALS demographics, clinical features, or healthcare in Arab countries. Data were pooled using a random-effects model.
Results:
Ten studies met inclusion: eight on ALS patient cohorts and two on healthcare systems. Research activity has increased in recent years, notably in Egypt and Tunisia. The pooled mean age at onset was 50.2 years (95% CI: 45.7–54.7). Males comprised 66.2% (95% CI: 62.1–70.3) of patients; bulbar onset occurred in 22.6% (95% CI: 19.4–25.9). Familial ALS prevalence was 12.6% (95% CI: 5.7–19.5). Healthcare studies consistently reported limited specialized services, delayed diagnosis, and inadequate multidisciplinary care.
Conclusions:
ALS in Arab countries shows both similarities and distinctive differences from global patterns. The evidence base remains limited, and healthcare infrastructure for ALS is underdeveloped. Expanding research and improving care delivery are urgent priorities for the region.
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