Over 600 million people aged 18-65 will have headache tomorrow: global 1-day prevalence and recall bias from a meta-analysis of individual participant data (N = 38,512) from the general populations of 15 countries.
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Husøy Andreas Kattem, Yu Shengyuan, Liu Ruozhuo, Herekar Akbar A, Ahmed Bilal, Herekar Arif D, Kuate Tegueu Callixte, Dzudie Tamdja Anastase, Magnerou Annick Mélanie, Kissani Najib, Adarmouch Latifa, Adoukonou Thierry, Agbetou Mendinatou, Kossi Oyéné, Zebenigus Mehila, Tekle-Haimanot Redda, Worku Dawit K, Rao Girish N, Kulkarni Girish B, Gururaj Gopalkrishna, Al Jumah Mohammed, Al Khathaami Ali M, Kojan Suliman, Quispe Guiovanna, Palomino-Diaz Carlos, Maiga Youssoufa, Cowan Robert P, Linde Mattias, Risal Ajay, Chowdhury Debashish, Anand Krishnan, Duggal Ashish, Luvsannorov Otgonbayar, Baldorj Dorjkhand, Enkhtuya Selenge, Ayzenberg Ilya, Katsarava Zaza, Birbeck Gretchen L, Rastenytė Daiva, Stovner Lars Jacob, Steiner Timothy J
Аннотация
METHODS: We performed a meta-analysis of individual participant data from cross-sectional surveys among population-representative samples (age range 18-65 years) from 15 countries and all world regions. All used the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, including the question "did you have a headache yesterday?", from which 1-day prevalence was determined. An algorithmic process applying modified ICHD criteria yielded separate estimates for migraine, tension-type headache (TTH) and probable medication-overuse headache (pMOH: the association of headache on ≥ 15 days/month and medication overuse). We analysed associations with age, gender and country-income level, and adjusted prevalence estimates for these factors. We calculated predicted 1-day prevalence from 1-year prevalence and reported headache frequency.
RESULTS: Among the 38,512 participants, females (53.4%) and participants from low- (17.1%) or lower-middle-income countries (64.6%) were overrepresented, but age distribution fairly matched that of the world. Overall, 13.7% (95% CI: 13.3-14.0) reported headache yesterday, females (17.1% [16.6-17.6]) more than males (9.7% [9.3-10.2]). Migraine was the most common headache type yesterday (6.0% [5.8-6.3]), followed by TTH (4.1% [3.9-4.3]) and pMOH (2.3% [2.2-2.5]). One-day headache prevalence was higher in low/lower-middle-income countries (13.9% [13.6-14.3]) than in high/upper-middle-income countries (12.4% [11.6-13.2]). Predicted 1-day prevalence (10.9% [10.7-11.1]) was considerably lower than observed 1-day prevalence (13.7% [13.3-14.0]), although not among those with pMOH (3.1% [3.0-3.3] versus 2.3% [2.2-2.5]). Adjusted for age, gender and country-income level, global 1-day prevalence estimates were 13.1% (12.8-13.5) for any headache, 5.7% (5.5-5.9) for migraine, 3.9% (3.7-4.1) for TTH and 2.4% (2.3-2.6) for pMOH, with 1.0% undiagnosed.
CONCLUSION: Assuming yesterday was no different from any other day, an estimated 13.1% (N = 641,900,000) of the world's population aged 18-65 years will have headache tomorrow; almost half will be migraine. People with migraine or TTH underestimate the frequency of headache episodes. Since headache-attributed burden is usually estimated from recalled frequency over 1-12 months, this also may be underestimated.