Abstract
Objective: To determine the prevalence of primary headache among school children in the age group of 11-16 years in the Polonnaruwa educational zone. Method: This was a school based cross sectional study. Study population was school children aged 11-16 years in Polonnaruwa educational zone. A self-administered questionnaire was used for screening. In those identified, a clinical examination and second questionnaire were used to collect further data. The diagnosis of migraine and tension type headache was based on the second edition of the International Headache Society’s International Classification of Headache Disorders (ICHD II). Results: A total of 683 students aged 11-16 years were invited to participate in this study out of which 606 responded (88.5%).The median age of the study sample was 13 years (Interquartile range 12-15). There was a slight female predominance (50.7%). Except for 32 (5.3%) students, all others experienced headache at least once in their lifetime and 541 (89.3%) had headache during past 12 months. Recurrent headache for at least for 3 months was reported by 39.8%, and 86.4% (208) of them had presented at least once to the General Hospital Polonnaruwa for evaluation previously. After further evaluation, 194 students were found to have primary headaches and secondary causes were found in the balance 14. The prevalence of migraine in this study sample was 7.8%, with 53.2% having migraine with aura. The prevalence of tension type headache was 2.81%. Majority (67%) of the 194 with primary headache had unclassified headache. Migraine was more common among girls (9.1%) compared to boys (6.4%). However, this observed high prevalence was not statistically significant (p=0.204). Tension and unclassified headaches had no variation according to the age and sex. Conclusions: Primary headaches occurred in 94% of children aged 11-16 years in the Polonnaruwa educational zone. The prevalence of migraine was 7.8%.
Highlights
Headache is reported to occur in up to 25% of younger children and 75% of adolescents[1] and the incidence has substantially increased over the last 30 years[2]
Recurrent headache for at least for 3 months was reported by 39.8%, and 86.4% (208) of them had presented at least once to the General Hospital Polonnaruwa for evaluation previously
After further 1Consultant Paediatrician, Base Hospital, Thabutthegama, 2Senior Lecturer and Consultant Paediatric Neurologist, Faculty of Medicine, University of Colombo, 3Consultant Community Physician, Head, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, 4Consultant Paediatrician, Teaching Hospital Anuradhapura. *Correspondence: chamilatp@gmail.com (Received on 23 October 2015: Accepted after revision on 20 December 2015) The authors declare that there are no conflicts of interest Personal funding was used for the project
Summary
Headache is reported to occur in up to 25% of younger children and 75% of adolescents[1] and the incidence has substantially increased over the last 30 years[2]. A study from Kashmir valley, India reported an overall prevalence of 664/1000 of primary headache disorders in school children[5]. A study performed in Taiwan showed that 85% of their children aged 13-15 years have had headaches[6]. Migraine is said to be the most common cause of primary headache in children[7]. Prevalence of migraine headache in the USA ranged from 1.2%3.5% in 3 to 7 year old children, 4%-11% in 7 to 11 year old children and 8%-23% in adolescents[7]. Though there are many studies about childhood primary headache internationally, there is no literature on prevalence of same in Sri Lankan children
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