Francesc Graus reports royalties from Euroimmun for the use of IgLON5 as a diagnostic test and honoraria for assistant editor of MedLink Neurology. assessed the prevalence of MS among the inhabitants of three Turkish cities, two of which are located in the Black Sea region (Artvin SYN-115 (Tozadenant) and Ordu) and one located in the Mediterranean region (Gazipa?a) . These cities, Bmp8a which were chosen due to their location and low immigration rate, were reported to have an MS prevalence of 18.6, 55.5 and 52.0 cases per 100,000 inhabitants, respectively . Another study, which focussed around the prevalence of MS in the Middle Black Sea Region of Turkey, reported 43.2 cases per 100,000 inhabitants . Other studies have explained an MS prevalence of 41.1 cases per 100,000 inhabitants of Geyve (a rural area in the Black Sea Region) and of 101.4 cases per 100,000 inhabitants of the district of Maltepe (Istanbul) [15, 16]. Consequently, it is now believed that the true prevalence of MS in Turkey should be within these latter limits. On the other hand, with respect to specialist care and resources, Turkey seems to be in a fairly good position. According to Altinta?, you will find over 2000 neurologists in the country, of whom 118 are currently dedicated to studying and managing MS and other demyelinating diseases. The McDonald criteria are usually applied for diagnosis, and the number of available MRI scanners exceeds 800. Most therapies and DMDs are available and easily accessible to patients (through the public health system and/or private health insurances), and treatment strategies follow the international guidelines with minor local adjustments. Najib Kissani (University or college Hospital Mohamed VI, Morocco) resolved the prevalence and the progression of MS in Africa. African countries can be divided into three different zones according to their MS prevalence: the north, comprising countries such as Morocco, Tunisia, Egypt and Algeria, which is described as a moderate to high prevalence area (30C80 cases per 100,000 inhabitants); the south, namely South Africa, which is a moderate prevalence area (10C30 cases per 100,000 inhabitants); and the rest of sub-Saharan Africa, which is a very low prevalence area ( ?5 cases per 100,000 inhabitnts). This scenario, however, is likely driven by a high rate of underdiagnosis, stemming from your worrisome lack of resources and specialists in many sub-Saharan countries. Interestingly, and despite the low prevalence, MS cases in Africa seem to be characterized by a higher severity and a faster progression rate (when compared to the rest of the world). Indeed, in one Moroccan cohort including 380 patients with MS (372 of whom were Caucasian), the time to progression to an Expanded Disability Status Score (EDSS) of 6 was only 10?years. Importantly, this higher severity seems to be independent of the delay in diagnosis (which was 2.5?years in the Moroccan series). Other studies have reported similar styles in severity [17, 18], and Sidhom et alhighlighted that the higher severity in North Africans is usually independent of patient location (within or outside Africa) , which suggests a genetically driven explanation. Kissani also shared the results of a questionnaire he sent to his African colleaguesin an attempt to understand the true prevalence of MS in African countrieshighlighting not only the low quantity of MS cases reported, but also the comparably high incidence of neuromyelitis optica (NMO) and the problematic lack of resources and therapies (in most cases, the only treatments available were corticosteroids). Kissani finished SYN-115 (Tozadenant) his presentation by underpinning the necessity of more studies (supported by strong collaborations) to understandand tacklethe MS low prevalence/high severity dichotomy in Africa. Fu-Dong Shi (Tianjin Medical SYN-115 (Tozadenant) University or college General Hospital, China) discussed the MS scenery in China, focussing on the latest improvements in the diagnosis and treatment of both MS and NMO Spectrum Disorder (NMOSD). The prevalence of MS in China is usually unknown; however, when data from Hong Kong and the neighbouring countries of Japan and Korea are taken.