Open AccessEnvironmental risk factors of multiple sclerosis in the Middle East and North Africa region: A systematic review
Author(s) -
Hossein Maroufi,
Seyyed Hosein Mortazavi,
Mohammad Ali Sahraian,
Sharareh Eskandarieh
Publication year - 2021
Publication title -
current journal of neurology
Language(s) - English
Resource type - Journals
ISSN - 2717-011X
DOI - 10.18502/cjn.v20i3.7693
Subject(s) - multiple sclerosis , middle east , geography , medicine , environmental health , archaeology , immunology
Background: The environmental factors play a major role as risk factors of multiple sclerosis (MS). This study aimed at gathering environmental risk factors of MS in the Middle East and North Africa (MENA). Methods: We used MEDLINE and EMBASE databases by a systematic review method. Out of a total of 123 studies, 16 studies met the eligibility criteria. Results: Totally, 47 risk factors were assessed as follows: six studies found sunlight exposure as a protective factor with the odds ratio (OR) ranging from 0.06 to 0.57. Six studies evaluated smoking as a risk factor with the OR ranging from 1.69 in all patients to 6.48 in female patients. Four studies supported measles infection as a risk factor with the OR ranging from 1.60 to 3.77, and in 3 studies, stressful events had a significant association with the OR of 1.80, 1.90, and 32.57. Conclusion: Among 47 assessed risk factors, sunlight exposure, cigarette smoking, measles infection, Epstein-Barr virus (EBV) infection, and stressful events had a significant association with MS.