Abstract
BackgroundIn the ongoing Global Campaign endeavour to improve knowledge and awareness of headache prevalence worldwide, Mongolia is a country of interest. It sits between Russia and China, in which prevalence is, respectively, much higher and much lower than the estimated global mean. We conducted a population-based study in Mongolia both to add to knowledge and to inform local health policy.MethodsUsing standardized methodology with cluster random sampling, we selected Mongolian adults (aged 18–65 years) from five regions reflecting the country’s diversities. They were interviewed by trained researchers, cold-calling at their homes, using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaire following pilot-testing. ICHD-3 beta diagnostic criteria were applied.ResultsN = 2043 (mean age 38.0 [±13.4] years, 40% urban-dwelling and 60% rural), with a non-participation proportion of 1.7%. Males were somewhat underrepresented, for which corrections were made. The crude 1-year prevalence of any headache was 66.1% (95% CI: 64.0–68.2%), with a strong female preponderance (OR: 2.2; p < 0.0001). Age- and gender-adjusted prevalences were: migraine 23.1% (for females, OR = 2.2; p < 0.0001); tension-type headache (TTH) 29.1% (no gender difference); probable medication-overuse headache (pMOH) 5.7% (trending towards higher in females); other headache on ≥15 days/month 5.0% (for females, OR = 2.2; p = 0.0008). Unclassified cases were only 35 (1.7%). Any headache yesterday was reported by 410 (20.1%; for females, OR = 2.4; p < 0.0001). Only pMOH showed a strong association with age, peaking in middle years with a 5-fold increase in prevalence. Migraine showed a consistent association with educational level, while pMOH showed the reverse, and was also more common among other groups than among participants who were single (never married). Migraine was less common among rural participants than urban (OR: 0.80; p = 0.0326), while pMOH again showed the reverse (OR: 2.4; p < 0.0001). Finally, pMOH (but not migraine or TTH) was significantly associated with obesity (OR: 1.8; p = 0.0214).ConclusionHeadache disorders are common in Mongolia, with, most notably, a very high prevalence of headache on ≥15 days/month corroborated by the high prevalence of headache yesterday. The picture is very like that in Russia, and dissimilar to China. There are messages for national health policy.
Highlights
Headache disorders are acknowledged as the most prevalent cause of public ill health, affecting people in all countries, and as the second highest cause of disability worldwide [1,2,3]
Headache disorders are common in Mongolia, with, most notably, a very high prevalence of headache on ≥15 days/month corroborated by the high prevalence of headache yesterday
We focused on the headache disorders of public-health importance, the purposes being two-fold: to add to the global map of headache, and, more importantly, to inform public-health policy in the country
Summary
Headache disorders are acknowledged as the most prevalent cause of public ill health, affecting people in all countries, and as the second highest cause of disability worldwide [1,2,3]. Of particular interest in this context are the data from Russia [16] and China [17], countries with a common border, in both of which LTB has supported studies These had highly disparate findings: whereas prevalences were high in Russia for migraine (20.8%), TTH (30.8%) and, especially, headache on ≥15 days/month (10.5%), in China these were notably below global averages (9.3%, 10.8% and 1.0% respectively – even though headache disorders were still a substantial cause of public ill health here). Russia in this respect appears not so different from the Republic of Georgia [18] and Lithuania [19], countries of the former USSR. We conducted a population-based study in Mongolia both to add to knowledge and to inform local health policy
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