Mapping the prevalence of Epstein-Barr virus and multiple sclerosis in Middle East and North Africa: a systematic review and meta-analysis.
Sajjad Ghane Ezabadi, Faezeh Khodaie, Kosar Kohandel et al.
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In 30 seconds
This systematic review and meta-analysis mapped published estimates of multiple sclerosis (MS) prevalence and Epstein-Barr virus (EBV) seroprevalence in Middle East and North Africa populations. It included 131 observational studies identified through searches up to 18 June 2022. Pooled MS prevalence was 51.02 per 100,000 population, and pooled EBV VCA-IgG seroprevalence was 75%. Across time-stratified studies, both estimates rose, with a larger increase for MS. The authors describe co-occurring trends in the available literature, while noting extreme between-study heterogeneity.
Key findings
- Pooled MS prevalence was 51.02 per 100,000 population across the included MENA studies.
- Pooled EBV VCA-IgG seroprevalence was 75%.
- Pooled MS prevalence rose from 12 per 100,000 in studies conducted up to 2000 to 58 per 100,000 in studies conducted from 2011 to 2022.
- EBV seroprevalence increased from 71 to 75% across the same study periods; heterogeneity was extreme for both outcomes (I 2 = 100%).
Why it matters
The review brings together regional estimates of MS and EBV exposure and shows that both increased across study periods, with a more pronounced rise in MS. This provides context for investigating possible links between EBV and MS in MENA populations, but the parallel trends are ecological and do not establish that EBV caused the increase in MS.
What to keep in mind
Between-study heterogeneity was extreme (I 2 = 100%) for both outcomes, reflecting variation in geography, populations, methods, diagnostic approaches, and study periods. The comparison is based on published observational estimates.