Primary headache disorders in the adult general population of Pakistan – a cross sectional nationwide prevalence survey

The Journal of Headache and Pain

Research Article

M. A. Shahab¹  T. J. Steiner²  Rafiq Khanani³  S. Z. Alvi⁴  A. D. Herekar⁵  B. Ahmed⁶  A. A. Herekar⁷  A. Ahmad⁸  J. Effendi⁸  U. L. Uqaili⁸  U. Javed⁹ 

[1] Aga Khan Medical College, Aga Khan Medical University Hospital, Karachi, Pakistan;Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Edvard Griegs Gate, NO-7491, Trondheim, Norway;Division of Brain Sciences, Imperial College London, London, UK;Department of Pathology and Microbiology Department at Dow University of Health Sciences, Karachi, Pakistan;Headache Research Foundation of Pakistan, Karachi, Pakistan;Department of Medicine, University of Nevada, Las Vegas, USA;Headache Research Foundation of Pakistan, Karachi, Pakistan;Department of Neurology, Baqai Medical University, Karachi, Pakistan;Headache Research Foundation of Pakistan, Karachi, Pakistan;Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida College of Medicine, Gainesville, FL, USA;Headache Research Foundation of Pakistan, Karachi, Pakistan;Department of Surgery, University of Texas at San Antonio, San Antonio, TX, USA;Headache Research Foundation of Pakistan, Karachi, Pakistan;Dow University of Health Sciences, Karachi, Pakistan;School of International and Public Affairs, Columbia University, New York, NY, USA;

关键词: Headache disorders;    Migraine;    Tension-type headache;    Medication-overuse headache;    Epidemiology;    Prevalence;    Population-based survey;    Eastern Mediterranean Region;    Pakistan;    Global campaign against headache;   

DOI  :  10.1186/s10194-017-0734-1

 received in 2017-01-19, accepted in 2017-02-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe large geographical gaps in our knowledge of the prevalence and burden of headache disorders include almost all of Eastern Mediterranean Region (EMR). We report a nationwide population-based study in Pakistan, an EMR country with the sixth largest population in the world, conducted as a project within the Global Campaign against Headache.MethodsWe surveyed six locations from the four provinces of Pakistan: Punjab, Sindh, Khyber Pakhtunkhwa and Baluchistan. We randomly selected and visited rural and urban households in each. One adult member (18–65 years) of each household, also randomly selected, was interviewed by a trained non-medical interviewer from the same location using a previously-validated structured questionnaire translated into Urdu, the national language. We estimated 1-year prevalences of the headache disorders of public-health importance and examined their associations with demographic variables using multivariate analysis.ResultsThere were 4223 participants (mean age 34.4 ± 11.0 years; male 1957 [46.3%], female 2266 [53.7%]; urban 1443 [34.2%], rural 2780 [65.8%]). Participation proportion was 89.5%. Headache in the previous year was reported by 3233 (76.6% [95% CI: 75.3–77.8%]). The age- and gender-adjusted 1-year prevalence of migraine was 22.5% [21.2–23.8%] (male 18.0% [16.8–19.2%], female 26.9% [25.6–28.2%]), of tension-type headache (TTH) 44.6% [43.1–46.1%] (male 51.2% [49.7–52.7%], female 37.9% [36.4–39.4%]), of probable medication-overuse headache 0.7% [0.5–1.0%] (male 0.7% [0.5–1.0%], female 0.8% [0.5–1.1%]) and of other headache on ≥15 days/month 7.4% [6.6–8.2%] (male 4.4% [3.8–5.0%], female 10.4% [9.5–11.3%]). Migraine was more prevalent in females by a factor of 3:2 although this association barely survived (P = 0.039) after correcting for other factors. TTH was more prevalent in males by about 4:3 (P = 0.026). All headache and migraine were age-related, peaking in the age group 40–49 years; TTH peaked a decade earlier. Higher education (P = 0.004) and income (P = 0.001) were negatively associated with prevalence of migraine.ConclusionWith three quarters of its population affected, headache disorders must be on the public-health agenda of Pakistan. Worldwide, these disorders are the third leading cause of disability; information from specific enquiry into the burden attributable to headache disorders in this country is needed to inform health policy and priority-setting, and will be reported soon.

【 授权许可】

CC BY   
© The Author(s). 2017