Migraine Attack Frequency, Duration, and Pain Intensity: Disease Burden Derived From a Community-Based Survey in Northern Tanzania

Dent, Wolfgang; Stelzhammer, Brigitte; Meindl, Michael; Matuja, William; Schmutzhard, Erich; Winkler, Andrea Sylvia

doi:10.1111/j.1526-4610.2011.02009.x

Cited by 13 publications

(12 citation statements)

References 29 publications

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“…Migraine is a disabling neurological disorder with substantial impact on personal health, work productivity, QOL and co-morbidity with other chronic diseases [ 2 ]. The findings of our study and those of others from sub-Saharan Africa re-iterate that migraine is not a mere inconvenience as it is often portrayed [ 4 - 12 ] and support the need for physicians and policy makers to take action to improve the quality of headache care and access to treatment in sub-Saharan Africa.…”

Section: Discussionsupporting

confidence: 79%

“…In sub-Saharan Africa, where only five countries have contributed to primary headache disorder research, nine articles have been published in the span of almost ten years (1997–2006) [ 3 ]. In the past five years, there have been few studies investigating the burden of migraine [ 4 - 12 ] in accordance with International Classification of Headache Disorder (ICHD) criteria. A recent study conducted among Ethiopian adults found a migraine prevalence of 9.8% comparable to what is reported in occidental countries (10-15%) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Sleep disturbances and quality of life in Sub-Saharan African migraineurs

et al. 2015

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BackgroundAlthough in the past decade occidental countries have increasingly recognized the personal and societal burden of migraine, it remains poorly understood in Africa. No study has evaluated the impact of sleep disturbances and the quality of life (QOL) in sub-Saharan Africans with migraine.MethodsThis was a cross-sectional study evaluating adults, ≥ 18 years of age, attending outpatient clinics in Ethiopia. Standardized questionnaires were utilized to collect demographic, headache, sleep, lifestyle, and QOL characteristics in all participants. Migraine classification was based on International Classification of Headache Disorders (ICHD)-II criteria. The Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF) questionnaires were utilized to assess sleep quality and QOL characteristics, respectively. Multivariable logistic regression models were fit to estimate adjusted odds ratio (OR) and 95% confidence intervals (95% CI).ResultsOf 1,060 participants, 145 (14%) met ICHD-II criteria for migraine. Approximately three-fifth of the study participants (60.5%) were found to have poor sleep quality. After adjustments, migraineurs had over a two-fold increased odds (OR = 2.24, 95% CI 1.49-3.38) of overall poor sleep quality (PSQI global score >5) as compared with non-migraineurs. Compared with non-migraineurs, migraineurs were also more likely to experience short sleep duration (≤7 hours) (OR = 2.07, 95% CI 1.43-3.00), long sleep latency (≥30 min) (OR = 1.97, 95% CI 1.36-2.85), daytime dysfunction due to sleepiness (OR = 1.51, 95% CI 1.12-2.02), and poor sleep efficiency (<85%) (OR = 1.93, 95% CI 1.31-2.88). Similar to occidental countries, Ethiopian migraineurs reported a reduced QOL as compared to non-migraineurs. Specifically Ethiopian migraineurs were more likely to experience poor physical (OR = 1.56, 95% CI 1.08-2.25) and psychological health (OR = 1.75, 95% CI 1.20-2.56), as well as poor social relationships (OR = 1.56, 95% CI 1.08-2.25), and living environments (OR = 1.41, 95% CI 0.97-2.05) as compared to those without migraine.ConclusionSimilar to occidental countries, migraine is highly prevalent among Ethiopians and is associated with poor sleep quality and a lower QOL. These findings support the need for physicians and policy makers to take action to improve the quality of headache care and access to treatment in Ethiopia.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Sleep disturbances and quality of life in Sub-Saharan African migraineurs

et al. 2015

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“…Swartz et al 5 using the Epidemiology Catchment Area Follow-up Study reported a similar strong association between migraine and major depression (OR=3.1; 95% CI 2.0,4.8). Similarly, Breslau et al 10 in demonstrated that the prevalence of major depression was 3-times higher in persons with migraine compared to controls.…”

Section: Discussionmentioning

confidence: 85%

“…Globally, migraine is a major cause of disability 3 . Although there is a strong body of research on migraine and its impact on lost productivity costs in high income countries, the epidemiology of migraine in sub-Saharan Africa is not well documented 4, 5 . In the past two decades, very few studies have evaluated the burden of migraine in sub-Saharan Africa 6-10 using the International Classification of Headache Disorder (ICHD) criteria 11 .…”

Section: Introductionmentioning

confidence: 99%

Migraine and Psychiatric Comorbidities Among Sub‐Saharan African Adults

et al. 2012

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Background Despite being a highly prevalent disorder and substantial cause of disability, migraine is understudied in Africa. Moreover, no previous study has investigated the effects of stress and unipolar psychiatric comorbidities on migraine in a sub-Saharan African cohort. Objective To evaluate the prevalence of migraine and its association with stress and unipolar psychiatric comorbidities among a cohort of African adults. Methods This was a cross-sectional epidemiologic study evaluating 2,151 employed adults in sub-Saharan Africa. A standardized questionnaire was used to identify socio-demographic, headache, and lifestyle characteristics of participants. Migraine classification was based on the International Classification of Headache Disorders (ICHD)-2 diagnostic criteria. Depressive, anxiety and stress symptoms were ascertained with the Patient Health Questionnaire (PHQ-9) and the Depression Anxiety Stress Scale (DASS-21) respectively. Multivariable logistic regression models were used to estimate adjusted odds ratio (OR) and 95% confidence intervals (CI). Results A total of 9.8% (n=212) of study participants fulfilled criteria for migraine (9.8%; 95%CI: 8.6, 11.1) with a higher frequency among women (14.3%; 95%CI: 11.9, 16.6) than men (6.9%; 95%CI: 5.5, 8.3). Similar to predominantly Caucasian migraine cohorts, sub-Saharan African migraineurs were more likely to be younger, have a lower education and more likely to report a poor health status than non-migraineurs. However, in contrast to historical reports in predominantly Caucasian migraine cohorts, sub-Saharan African migraineurs were less likely to report smoking than non-migraineurs. Participants with moderately severe depressive symptoms had over a 3-fold increased odds of migraine (OR=3.36; 95% CI 1.30,8.70), compared with those classified as having minimal or no depressive symptoms; and the odds of migraine increased with increasing severity of depressive symptoms (p-trend <0.001). Similarly those with mild, moderate and severe anxiety symptoms had increased odds of migraine (OR=2.28; 95%CI 1.24, 4.21; OR=1.77; 95%CI 0.93, 3.35, and OR=5.39; 95%CI 2.19, 13.24, respectively). Finally, those with severe stress had a 3.57-fold increased odds of migraine (OR=3.57; 95%CI 1.35, 9.46). Conclusion Although historically it has been reported that migraine prevalence is greater in Caucasians than African Americans, our study demonstrates a high migraine prevalence among urban dwelling Ethiopian adults (9.9%) that is comparable to what is typically reported in predominantly Caucasian cohorts. Further, among employed sub-Saharan African adults, and similar to predominantly Caucasian populations, migraine is strongly associated with stress and unipolar psychiatric symptoms. The high burden of migraine and its association with stress and unipolar psychiatric symptoms in our study of well-educated and urban dwelling African adults has important clinical and public health implications pending confirmation in other African populations.

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“…Of the 25 articles selected, all were subsequently rejected. Ten applied different definitions of headacheattributed disability and/or lost productivity, incompatible with ours [37][38][39][40][41][42][43][44][45][46]. Two did not measure both [47,48].…”

Section: Resultsmentioning

confidence: 99%

The relationship between headache-attributed disability and lost productivity: 1. A review of the literature

2021

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Background Headache disorders are disabling and have a significant impact on productivity. The relationship between these two consequences is of considerable economic and political interest. We enquired into it through a systematic search of the English-language literature. Methods We followed PRISMA guidelines in specifying search terms and syntax and in article selection. We used the term “disability” in the search, accepting any meaning that authors attached to it, but this proved problematic. Accordingly, we adopted the definition used in the Global Burden of Disease study. In article selection, we included only those that purported to measure disability as so defined and lost productivity. We reviewed the full texts of those selected. We included further articles identified from review of the bibliographies of selected articles. Results The literature search found 598 studies, of which 21 warranted further review. Their bibliographies identified another four of possible relevance. On full-text reading of these 25, all were rejected. Ten applied incompatible definitions of disability and/or lost productivity. Two did not measure both. Four reported lost productivity but not disability. Eight studies reported and measured both but did not assess the association between them or provide the means of doing so. One was purely methodological. Conclusions The literature is silent on the relationship between headache-attributed disability and lost productivity. In view of its health economic and political importance, empirical studies are required to remedy this. A prerequisite is to clarify what is meant by “disability” in this context.

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Migraine Attack Frequency, Duration, and Pain Intensity: Disease Burden Derived From a Community-Based Survey in Northern Tanzania

Cited by 13 publications

References 29 publications

Sleep disturbances and quality of life in Sub-Saharan African migraineurs

Sleep disturbances and quality of life in Sub-Saharan African migraineurs

Migraine and Psychiatric Comorbidities Among Sub‐Saharan African Adults

The relationship between headache-attributed disability and lost productivity: 1. A review of the literature

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