OBJECTIVE: To compare @entity15 ( @entity15 ) disability progression among North Africans (NAs) living in France ( @entity687 ) and in Tunisia (NAT) and Caucasian @entity1 born and living in France ( @entity1577 ). METHODS: @entity1 with @entity15 admitted to the day hospital in the Neurology Department at Piti  - @entity9574  tri  re Hospital (France) and Razi Hospital (Tunisia) were questioned on their place of birth and the place of birth of their parents. To compare delay to outcomes, log-rank tests were used. Univariate and multivariate Cox models were used to determine factors influencing time to Expanded Disability Status Scale (EDSS) 6. RESULTS: We consecutively included 462 @entity1 : 171 @entity1577 , 151 NAT, and 140 @entity687 . Sex ratio, disease forms, and delay from disease onset to diagnosis were similar between the groups. @entity687 differed from other groups, with a shorter median time to reach EDSS 3, 4, and 6, and a more frequent incomplete recovery after first relapse (p < 0.0001). Furthermore, the NA second-generation group showed the youngest median age at onset (26.5    8.8 years, p = 0.001), the shortest median time to EDSS 6 in relapsing-remitting @entity1 , and an increased mean number of relapses during the first 5 years of the disease (6.1    3.7, p = 0.01) compared to @entity1577 . The Cox proportional hazard models demonstrate that (1) NA ethnicity is a significant predictor of fast progression even when adjusting for major covariates and (2) treatment did not influence the models. CONCLUSION: Our study further supports severity of @entity15 in NAs and unravels the particular severity in NAs living in France, mainly for the second generation.

Fast XXXX progression in North Africans: Both genetics and environment matter.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity9574 :: ('10656', 'Gene') :: ['Salp'] @entity687 :: ('3576', 'Gene') :: ['NAF'] @entity15 :: ('MESH:D009103', 'Disease') :: ['MS', 'multiple sclerosis'] @entity1577 :: ('MESH:D003550', 'Disease') :: ['CF']
@entity15 :: (MESH:D009103,Disease) :: ['multiple sclerosis']
