Contents lists available at ScienceDirect Multiple Sclerosis and Related Disorders journal homepage: www.elsevier.com/locate/msard Original article Multiple sclerosis coverage in the written media of a low prevalence country Simón Cárdenas-Robledo a,b,c, ⁎ , Cristian Eduardo Navarro b,c , Claudia M. Guío-Sánchez a,c a Multiple Sclerosis Center, Department of Neurology, Hospital Universitario Nacional de Colombia. Bogotá, Colombia b Unit of Clinical Neurology, Department of Medicine, School of Medicine, Universidad Nacional de Colombia. Bogotá, Colombia c Grupo de Investigación en Neurología de la Universidad Nacional de Colombia – NEURONAL. Bogotá, Colombia ARTICLEINFO Keywords: Multiple sclerosis Communications media Access to information Medical journalism ABSTRACT Background: Awareness in the community is an important factor across a wide range of diseases and the com- munication media have an important role in its promotion. However, misinformation and misguide may take place heightening the expectations of people affected by chronic conditions such as multiple sclerosis (MS). This study explores media coverage of MS in a low prevalence country. Methods: We identified the most important written media at national and local levels and performed a search in their digital archives and social media with the words "Multiple Sclerosis". The articles found were categorized as relevant, and non-relevant. We describe the total number, number of relevant and non-relevant articles pub- lished every year, since the earliest found until 2018. We identified the topics covered by the relevant articles and described their distribution and performed a quality evaluation of their content. Results: We reviewed the archives of 20 sources. A total of 976 articles where MS was mentioned were reviewed (relevant: 143 [14.6%]; non-relevant: 833 [85.4%]). We observed a steady increase in the annual publication rate, from the first in 1991 up to 107 in 2018. The most frequent covered topic was disease modifying therapies and MS itself, and the least documented topic was rehabilitation. Most of the relevant articles had low quality scores. Conclusion: The media coverage of different topics MS has risen steadily since its first appearance in the early nineties. This should be encouraged, but caution should be held so misinformation is not propagated. We call for the public to discuss misleading information with their healthcare providers. 1. Introduction Media coverage is a key player in the diffusion of healthcare related information in the community. The spread of accurate and inaccurate information has a profound effect in health-related behavior across several areas of medicine (Basky, 1999), ranging from epidemics (Tchuenche et al., 2011) to mental health (Lu et al., 2014). The advent of the internet has widened the scope and spread capacity of the pieces of information, broadening their effects on people's behavior. There is a strong correlation between the amount of information published con- cerning a specific disease and its prevalence (Anema et al., 2010). Prevalence of multiple sclerosis (MS) in Colombia is low (Sánchez et al., 2000; Toro et al., 2007). Although it is seemingly rising (Jiménez- Pérez et al., 2015), we have witnessed what we feel to be a dis- proportionate increase in the volume of media coverage over the last few years. Our aim was to explore this increment and to describe the subjects related to MS published in the lay press. 2. Materials and methods We first identified all the written media of the country in a web- based spanish lay press database (www.prensaescrita.com). On the basis of the scope of the publications, we excluded those addressing sports, celebrities and sensationalistic news. This exclusion was decided by consensus and based on some characteristics that have been cited as typical of tabloids (González Díez et al., 2015). After this we searched for the words “Multiple Sclerosis” (in spanish) in the web-archive, Twitter® profile, Facebook® page and Instagram® profile of the each newspapers selected. All the articles retrieved were reviewed in- dependently by two of the authors (SCR, CMG) and categorized as re- levant and non-relevant, according to the following criteria: • Relevant articles were those dealing directly with MS; its causes, disease-modifying treatments (DMT), physiopathology, diagnostic criteria, etc.; or as considered by each reviewer. • Non-relevant articles were those that mentioned MS, but in which https://doi.org/10.1016/j.msard.2020.102266 Received 26 January 2020; Received in revised form 30 May 2020; Accepted 3 June 2020 ⁎ Corresponding author: Multiple Sclerosis Center, Hospital Universitario Nacional de Colombia, Calle 44 # 59-75. Bogotá 111321, Colombia. E-mail address: simon.cardenas@hun.edu.co (S. Cárdenas-Robledo). Multiple Sclerosis and Related Disorders 44 (2020) 102266 2211-0348/ © 2020 Elsevier B.V. All rights reserved. T