Global epidemiology of mucopolysaccharidosis type III (Sanfilippo syndrome): an updated systematic review and meta-analysis

J Pediatr Endocrinol Metab. 2021 Jul 19;34(10):1225-1235. doi: 10.1515/jpem-2020-0742. Print 2021 Oct 26.

Abstract

Objectives: Mucopolysaccharidosis III, an autosomal recessive lysosomal storage disorder, is characterized by progressive mental retardation and behavioral problems. Meta-analysis of global mucopolysaccharidosis III epidemiology, which serves as a fundamental reference for public health decision-making, was not available prior to this study. To provide a systematic review and meta-analysis of birth prevalence of mucopolysaccharidosis III in multiple countries.

Methods: MEDLINE and EMBASE databases were searched for original research articles on the epidemiology of mucopolysaccharidosis III from inception until 1st July, 2020. A checklist adapted from STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) was used to assess the quality of all studies involved. Meta-analysis, adopting a random effects logistic model, was performed to estimate pooled birth prevalence of mucopolysaccharidosis III and its subtypes.

Results: Twenty-five studies screened out of 1,826 records were included for data extraction. The pooled global mucopolysaccharidosis III birth prevalence was 0.76 cases (95% CI: 0.57-0.96) per 100,000 live births. The pooled global birth prevalence of mucopolysaccharidosis III subtypes (A, B, and C) was 0.52 cases (95% CI: 0.33-0.72), 0.21 cases (95% CI: 0.12-0.30) and 0.01 cases (95% CI: 0.005-0.02) per 100,000 live births, respectively.

Conclusions: Based on the global population size (7.8 billion) and the life span of patients, there would be 12-19 thousand mucopolysaccharidosis III patients worldwide. To our knowledge, this is the first comprehensive systematic review that presented quantitative data fundamental for evidence-based public health decision-making by evaluating global epidemiology of mucopolysaccharidosis III.

Keywords: Sanfilippo syndrome; birth prevalence; epidemiology; meta-analysis; mucopolysaccharidoses; mucopolysaccharidosis III; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Global Health / statistics & numerical data*
  • Humans
  • Infant, Newborn
  • Mucopolysaccharidosis III / diagnosis
  • Mucopolysaccharidosis III / epidemiology*
  • Neonatal Screening
  • Prevalence