The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates

Lars Jacob Stovner, Knut Hagen, Mattias Linde, Timothy J Steiner, Lars Jacob Stovner, Knut Hagen, Mattias Linde, Timothy J Steiner

Abstract

Background: According to the Global Burden of Disease (GBD) study, headache disorders are among the most prevalent and disabling conditions worldwide. GBD builds on epidemiological studies (published and unpublished) which are notable for wide variations in both their methodologies and their prevalence estimates. Our first aim was to update the documentation of headache epidemiological studies, summarizing global prevalence estimates for all headache, migraine, tension-type headache (TTH) and headache on ≥15 days/month (H15+), comparing these with GBD estimates and exploring time trends and geographical variations. Our second aim was to analyse how methodological factors influenced prevalence estimates.

Methods: In a narrative review, all prevalence studies published until 2020, excluding those of clinic populations, were identified through a literature search. Prevalence data were extracted, along with those related to methodology, world region and publication year. Bivariate analyses (correlations or comparisons of means) and multiple linear regression (MLR) analyses were performed.

Results: From 357 publications, the vast majority from high-income countries, the estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9-55.4), of migraine 14.0% (12.9-15.2), of TTH 26.0% (22.7-29.5) and of H15+ 4.6% (3.9-5.5). These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. Each day, 15.8% of the world's population had headache. MLR analyses explained less than 30% of the variation. Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). With these taken into account, migraine prevalence estimates increased over the years, while estimates for all headache types varied between world regions.

Conclusion: The review confirms GBD in finding that headache disorders remain highly prevalent worldwide, and it identifies methodological factors explaining some of the large variation between study findings. These variations render uncertain both the increase in migraine prevalence estimates over time, and the geographical differences. More and better studies are needed in low- and middle-income countries.

Keywords: Global campaign against headache; Headache; Methodology; Migraine; Narrative review; Prevalence; Tension-type headache.

Conflict of interest statement

The authors have no competing interest with regard to the present review.

© 2022. The Author(s).

References

    1. Steiner TJ, Saraceno B, Prilipko L, McGillicuddy L, Shannon K, Tfelt-Hanmsen P, South V, Lainez M. Lifting the burden: The global campaign against headache. Lancet Neurol. 2004;3:204–205. doi: 10.1016/S1474-4422(04)00703-3.
    1. Stovner LJ, Nichols E, Steiner TJ, et al. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17:954–976. doi: 10.1016/S1474-4422(18)30322-3.
    1. Steiner TJ, Stovner LJ, Jensen R, Uluduz D, and Katsarava (2020) Migraine remains second among the world's causes of disability, and first among young women: findings from GBD2019. J Headache Pain 21: 137
    1. Stovner LJ, Al Jumah M, Birbeck GL, Gururaj G, Jensen R, Katsarava Z, Queiroz LP, Scher AI, Tekle-Haimanot R, Wang SJ, Steiner TJ. The methodology of population surveys of headache prevalence, burden and cost: Principles and recommendations from the Global Campaign against Headache. J Headache Pain. 2014;15:5. doi: 10.1186/1129-2377-15-5.
    1. Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner T, Zwart JA. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210. doi: 10.1111/j.1468-2982.2007.01288.x.
    1. Woldeamanuel YW, Cowan RP. Migraine affects 1 in 10 people worldwide featuring recent rise: A systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci. 2017;372:307–315. doi: 10.1016/j.jns.2016.11.071.
    1. El-Metwally A, Toivola P, AlAhmary K, Bahkali S, AlKhathaami A, Al Ammar SA, Altamimi IM, Alosaimi SM, Jawed M, Almustanyir S. The Epidemiology of Migraine Headache in Arab Countries: A Systematic Review. ScientificWorldJournal. 2020;2020:4790254. doi: 10.1155/2020/4790254.
    1. Abu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies. Dev Med Child Neurol. 2010;52:1088–1097. doi: 10.1111/j.1469-8749.2010.03793.x.
    1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38:1–211.
    1. Headache Classification Committee of the International Headache Society Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8(Suppl 7):1–96.
    1. Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders. 2nd Edition. 24: 1–160
    1. Hagen K, Zwart JA, Aamodt AH, Nilsen KB, Brathen G, Helde G, Stjern M, Tronvik EA, Stovner LJ. A face-to-face interview of participants in HUNT 3: the impact of the screening question on headache prevalence. J Headache Pain. 2008;9:289–294. doi: 10.1007/s10194-008-0062-6.
    1. IHME (2020) GBD Results Tool. . Accessed 20 Mar 2021
    1. Migliavaca CB, Stein C, Colpani V, Munn Z, Falavigna M. Quality assessment of prevalence studies: a systematic review. J Clin Epidemiol. 2020;127:59–68. doi: 10.1016/j.jclinepi.2020.06.039.
    1. Steiner TJ, Gururaj G, Andree C, Katsarava Z, Ayzenberg I, Yu SY, Al Jumah M, Tekle-Haimanot R, Birbeck GL, Herekar A, Linde M, Mbewe E, Manandhar K, Risal A, Jensen R, Queiroz LP, Scher AI, Wang SJ, Stovner LJ. Diagnosis, prevalence estimation and burden measurement in population surveys of headache: presenting the HARDSHIP questionnaire. J Headache Pain. 2014;15:3. doi: 10.1186/1129-2377-15-3.
    1. Linde M, Edvinsson L, Manandhar K, Risal A, Steiner TJ. Migraine associated with altitude: results from a population-based study in Nepal. Eur J Neurol. 2017;24:1055–1061. doi: 10.1111/ene.13334.
    1. Linde M, Stovner LJ, Zwart JA, Hagen K. Time trends in the prevalence of headache disorders. The Nord-Trondelag Health Studies (HUNT 2 and HUNT 3) Cephalalgia. 2011;31:585–596. doi: 10.1177/0333102410391488.
    1. Wang SJ, Fuh JL, Juang KD, Lu SR. Rising prevalence of migraine in Taiwanese adolescents aged 13-15 years. Cephalalgia. 2005;25:433–438. doi: 10.1111/j.1468-2982.2005.00873.x.
    1. Lipton RB, Scher AI, Kolodner K, Liberman J, Steiner TJ, Stewart WF. Migraine in the United States: epidemiology and patterns of health care use. Neurology. 2002;58:885–894. doi: 10.1212/WNL.58.6.885.
    1. Lyngberg AC, Rasmussen BK, Jorgensen T, Jensen R. Has the prevalence of migraine and tension-type headache changed over a 12-year period? A Danish population survey. Eur J Epidemiol. 2005;20:243–249. doi: 10.1007/s10654-004-6519-2.
    1. Evans RW, Lipton RB, Silberstein SD. The prevalence of migraine in neurologists. Neurology. 2003;61:1271–1272. doi: 10.1212/01.WNL.0000090628.46508.D4.
    1. Donnet A, Becker H, Allaf B, Lanteri-Minet M. Migraine and migraines of specialists: perceptions and management. Headache. 2010;50:1115–1125. doi: 10.1111/j.1526-4610.2010.01660.x.
    1. Alstadhaug KB, Hernandez A, Naess H, Stovner LJ. Migraine among Norwegian neurologists. Headache. 2012;52:1369–1376. doi: 10.1111/j.1526-4610.2012.02216.x.
    1. Wober C, Wober-Bingol C, Uluduz D, Aslan TS, Uygunoglu U, Tufekci A, Alp SI, Duman T, Surgun F, Emir GK, Demir CF, Balgetir F, Ozdemir YB, Auer T, Siva A, Steiner TJ. Undifferentiated headache: broadening the approach to headache in children and adolescents, with supporting evidence from a nationwide school-based cross-sectional survey in Turkey. J Headache Pain. 2018;19:18. doi: 10.1186/s10194-018-0847-1.
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–2196. doi: 10.1016/S0140-6736(12)61729-2.
    1. GBD Disease and Injury Incidence and Prevalence Collaborators (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2015;388:1545–1602.
    1. Global Health Data Methods. . Accessed 1 Nov. 2021
    1. Linde M and Dahlöf C (2004) Attitudes and burden of disease among self-considered migraineurs--a nation-wide population-based survey in Sweden. Cephalalgia 24: 455–465
    1. Steiner TJ, Linde M, Schnell-Inderst P. A universal outcome measure for headache treatments, care-delivery systems and economic analysis. J Headache Pain. 2021;22:63. doi: 10.1186/s10194-021-01269-9.
    1. Song TJ, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Sex Differences in Prevalence, Symptoms, Impact, and Psychiatric Comorbidities in Migraine and Probable Migraine: A Population-Based Study. Headache. 2019;59:215–223. doi: 10.1111/head.13470.
    1. Dent W, Spiss H, Helbok R, Matuja W, Scheunemann S, Schmutzhard E. Prevalence of migraine in a rural area in South Tanzania: a door-to-door survey. Cephalalgia. 2004;24:960–966. doi: 10.1111/j.1468-2982.2004.00775.x.
    1. Alp R, Alp SI, Palanci Y, Sur H, Boru UT, Ozge A, Yapici Z. Use of the International Classification of Headache Disorders, Second Edition, criteria in the diagnosis of primary headache in schoolchildren: epidemiology study from eastern Turkey. Cephalalgia. 2010;30:868–877. doi: 10.1177/0333102409355837.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren