Abstract
BackgroundThe Global Burden of Disease (GBD) study establishes headache as the second-highest cause of disability worldwide. Because most headache data in GBD are from adults, leading to underestimation of headache-attributed burden, a global schools-based programme within the Global Campaign against Headache is contributing data from children (7–11 years) and adolescents (12–17 years). This national study in Ethiopia is the first in this programme reported from sub-Saharan Africa.MethodsA cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. Structured questionnaires were self-completed under supervision by pupils within their classes. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH).ResultsOf 2349 potential participants, 2344 completed the questionnaire (1011 children [43.1%], 1333 adolescents [56.9%]; 1157 males [49.4%], 1187 females [50.6%]), a participation proportion of 99.8%. Gender- and age-adjusted 1-year prevalence of headache was 72.8% (migraine: 38.6%; tension-type headache: 19.9%; UdH: 12.3%; all headache on ≥15 days/month: 1.2%; probable medication-overuse headache: 0.2%). Headache was more prevalent in females (76.2%) than males (71.0%), a finding reflected only in migraine among the headache types. Headache was more prevalent among adolescents (77.6%) than children (68.4%), reflected in all types except migraine, although prevalence of UdH fell sharply after age 14 years to 3.9%.For headache overall, findings matched those in Turkey and Austria, obtained with the same questionnaire, but the high prevalence of migraine, not increasing with age, was surprising. The study highlighted diagnostic difficulties in young people, especially when poorly educated, with migraine diagnoses driven by improbably high proportions reporting nausea (44.8%) and vomiting (28.0%) as usual symptoms accompanying their headaches.ConclusionsHeadache is very common in children and adolescents in Ethiopia. This has major public-health implications, since half the country’s population are aged under 18 years.
Highlights
Over multiple iterations between 2000 and 2019, the Global Burden of Disease (GBD) study has demonstrated that headache disorders are a major cause of global ill health, to the extent of being the second highest cause of disability [1,2,3,4,5,6]
The principal contributors to this are migraine, tension-type headache (TTH), medication-overuse headache (MOH) and the group of other disorders characterized by headache occurring on ≥15 days/month
This paper reports prevalence; a later paper will report on burden
Summary
Over multiple iterations between 2000 and 2019, the Global Burden of Disease (GBD) study has demonstrated that headache disorders are a major cause of global ill health, to the extent of being the second highest cause of disability [1,2,3,4,5,6]. Termed “undifferentiated headache” (UdH), this is not diagnosable as migraine or TTH but believed to be expressions of these by the immature brain In these age groups, LTB is conducting a global schools-based programme using a standardised protocol [13] in multiple countries in each of the world’s six major regions, thereby cluster-sampling the world. Because most headache data in GBD are from adults, leading to underestimation of headacheattributed burden, a global schools-based programme within the Global Campaign against Headache is contributing data from children (7–11 years) and adolescents (12–17 years). This national study in Ethiopia is the first in this programme reported from sub-Saharan Africa
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
