Prevalence of neuromyelitis optica spectrum disorder in the multi-ethnic Penang Island, Malaysia, and a review of worldwide prevalence

Hor JY 1 , Lim TT 2 , Chia YK 3 , Ching YM 4 , Cheah CF 3 , Tan K 3 Show all authors , Chow HB 3 , Arip M 4 , Eow GB 3 , Easaw PES 5 , Leite MI 6

Affiliations 

  • 1 Department of Neurology, Penang General Hospital, Penang, Malaysia; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom. Electronic address: [email protected]
  • 2 Island Hospital, Penang, Malaysia
  • 3 Department of Neurology, Penang General Hospital, Penang, Malaysia
  • 4 Autoimmune Unit, Allergy & Immunology Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
  • 5 Department of Medicine, Penang Medical College, Penang, Malaysia
  • 6 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom. Electronic address: [email protected]
Mult Scler Relat Disord, 2018 Jan;19:20-24.
PMID: 29100047 DOI: 10.1016/j.msard.2017.10.015

Abstract

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) occurs worldwide in all ethnicities. Recently, population-based studies have shown that NMOSD is more common among non-White populations. There is scarce data about NMOSD prevalence in South East Asian populations.

METHODS: (1) A population-based study was undertaken to estimate NMOSD prevalence in the multi-ethnic Penang Island, Malaysia, comprising Chinese, Malays, and Indians. Medical records of NMOSD patients followed up at the Penang General Hospital (the neurology referral centre in Penang Island) were reviewed. The 2015 diagnostic criteria of the International Panel for NMO Diagnosis were used for case ascertainment. (2) A review of population-based prevalence studies of NMOSD worldwide was carried out. PubMed and conference proceedings were searched for such studies.

RESULTS: Of the 28 NMOSD patients, 14 were residents of Penang Island on prevalence day [13 (93%) Chinese and one (7%) Malay]. All 14 patients were females and aquaporin 4 seropositive. The prevalence of NMOSD in Penang Island was 1.99/100,000 population; according to ethnicities, the prevalence in Chinese was significantly higher than in Malays (3.31/100,000 vs 0.43/100,000, respectively, p = 0.0195).

CONCLUSION: Based on our and other population-based studies, among Asians, East Asian origin populations (Chinese and Japanese) appear to have higher NMOSD prevalence than other Asian ethnic groups. Worldwide, Blacks seem to have the highest NMOSD prevalence. More studies in different geographical regions and ethnic groups will be useful to further inform about potential factors in NMOSD pathogenesis.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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