Multiple Sclerosis in Jordan: A Clinical and Epidemiological Study

Objectives: To characterize the clinical, demographic and epidemiological features of multiple sclerosis (MS) in Jordan.

Methods: Data for consecutive Jordanian patients, fulfilling the McDonald criteria for clinically definite and clinically probable MS, during the time period 2004-2005 were collected and analyzed in the three major referral centers for MS in Jordan.

Results: We identified a total of 224 patients (165 females, 87%; 59 males, 13%). The mean (+/-SD) age of onset was 29.3 (+/-9.6) years, and mean (+/-SD) duration of illness was 3.9 (+/-9.3) years. The prevalence of MS in the city of Amman was 39/100,000. The prevalence of MS in Irbid, north Jordan, was 38/100,000. The most frequent presentation was weakness (30.8%), followed by optic neuritis (20.1%), sensory impairment (19.6%), and ataxia (14.3%). A relapsing remitting pattern was identified in 90.2% of patients, the rest being primary and secondary progressive, and one patient had a progressive relapsing course. Family history of MS was found in 9.4% of the cases. About 60% of the patients were using interferon beta. The degree of physical disability was determined using the Expanded Disability Status Scale (EDSS). Younger age of onset, shorter duration of illness, a relapsing remitting pattern, and use of interferon were identified as statistically significant predictors of less disability.

Conclusion: Jordan is a medium-high risk country for MS, with prevalence higher than what has previously been reported, possibly representing an increase in incidence. Clinical and demographic characteristics are similar to most reports worldwide.