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

• Published in: Clinical neurology and neurosurgery Vol. 240; p. 108255
• Main Authors: Alonso-Magdalena, Lucía, Carmona i Codina, Olga, Zia, Elisabet, Sundström, Peter, Pessah-Rasmussen, Hélène
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-05-2024; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Central nervous system; Country of birth; Demyelinating diseases; Demyelination; Diagnosis; Disability; Disability Evaluation; Disabled Persons - statistics & numerical data; Disease Progression; Emigrants and Immigrants - statistics & numerical data; Epidemiology; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Health Sciences; Humans; Hälsovetenskap; Immigrant; Immigrants; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Migration; Minority & ethnic groups; Multiple sclerosis; Multiple Sclerosis - epidemiology; Multiple Sclerosis - ethnology; Prevalence; Public Health, Global Health, Social Medicine and Epidemiology; Severity of Illness Index; Statistical analysis; Sweden; Sweden - epidemiology; Young Adult; Young adults; Sweden; Denmark; Norway; Disability; Multiple sclerosis; Sweden; Prevalence; Immigrant; Epidemiology
• ISSN: 0303-8467; 1872-6968; 1872-6968
• DOI: 10.1016/j.clineuro.2024.108255

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.
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.
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.
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.
•The MS prevalence in immigrants in Malmö in 2010 was lower than the native population.•This is the first study in Sweden regarding differences in disease disability among immigrants.•Non-western immigrants had a more severe disease than the Scandinavians.