Dinos, Sokratis, Khoshaba, Bernadette, Ashby, Deborah et al. · International journal of epidemiology · 2009 · DOI
This review looked at many studies to understand how ME/CFS (also called chronic fatigue syndrome) affects people from different ethnic backgrounds. The researchers found that African Americans and Native Americans may actually get ME/CFS more often than White Americans, which contradicts an older belief that it was mainly a condition affecting white, wealthy women. The study also found that people from minority ethnic groups with ME/CFS may experience more severe symptoms and may cope differently with their illness.
This study challenges the historical misconception that ME/CFS primarily affects white, affluent populations and suggests certain ethnic minorities bear a disproportionate disease burden. Understanding these epidemiological patterns and their underlying psychosocial and biological mechanisms is crucial for equitable clinical recognition, diagnosis, and treatment across diverse populations.
This review does not establish causation for why certain ethnic groups have higher CFS risk—only association. The limited available data means findings should be considered preliminary and warrant confirmation with larger, more diverse population studies. The study cannot prove whether observed differences result from genetic factors, differential healthcare access, measurement bias, or unmeasured psychosocial stressors.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Dinos, Sokratis, Khoshaba, Bernadette, Ashby, Deborah, White, Peter D, Nazroo, James, Wessely, Simon, et al. (2009). A systematic review of chronic fatigue, its syndromes and ethnicity: prevalence, severity, co-morbidity and coping.. International journal of epidemiology. https://doi.org/10.1093/ije/dyp147
BibTeX
@article{mecfsatlas-dinos-2009-systematic-review,
author = {Dinos, Sokratis and Khoshaba, Bernadette and Ashby, Deborah and White, Peter D and Nazroo, James and Wessely, Simon and Bhui, Kamaldeep S},
title = {A systematic review of chronic fatigue, its syndromes and ethnicity: prevalence, severity, co-morbidity and coping.},
journal = {International journal of epidemiology},
year = {2009},
doi = {10.1093/ije/dyp147},
note = {PubMed: 19349479},
url = {https://www.mecfsatlas.com/evidence/dinos-2009-systematic-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/dinos-2009-systematic-review
Contribute
Private, reviewed by a human. Not a public comment thread.