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The burden of headache disorders in Nepal: estimates from a population-based survey
BACKGROUND: Headache disorders, particularly migraine and tension-type headache (TTH), are among the most prevalent global public-health problems. Medication-overuse headache (MOH) is a common sequela of mismanagement of these. Migraine and MOH are highly disabling. Formulation of responsive health...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Milan
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4726638/ https://www.ncbi.nlm.nih.gov/pubmed/26810487 http://dx.doi.org/10.1186/s10194-016-0594-0 |
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author | Manandhar, Kedar Risal, Ajay Linde, Mattias Steiner, Timothy J. |
author_facet | Manandhar, Kedar Risal, Ajay Linde, Mattias Steiner, Timothy J. |
author_sort | Manandhar, Kedar |
collection | PubMed |
description | BACKGROUND: Headache disorders, particularly migraine and tension-type headache (TTH), are among the most prevalent global public-health problems. Medication-overuse headache (MOH) is a common sequela of mismanagement of these. Migraine and MOH are highly disabling. Formulation of responsive health policy requires reliable, locally-derived, population-based data describing both individual and societal impact of headache disorders. South-East Asia is the only one of WHO’s six world regions in which no such national data have yet been gathered. METHODS: In a nationwide population-based cross-sectional study, a representative sample of Nepalese-speaking adults (18–65 years) were randomly selected by stratified multistage cluster sampling. Trained interviewers made unannounced door-to-door visits and enquired into headache and its attributable burden using a culturally-adapted and validated Nepalese translation of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire. RESULTS: Among 2100 participants, 1794 (85.4 %) reported headache during the preceding year (male: 689 [38.4 %], female 1105 [61.6 %]; mean age 36.1 ± 12.6 years). Mean headache frequency was 3.8 ± 6.2 days/month, mean headache intensity 2.1 ± 0.7 on a 0–3 scale, and mean attack duration 41.9 ± 108.5 h. All aspects of symptom burden (frequency, intensity and duration) were greater among females (p < 0.001). Participants with headache had poorer quality of life (QoL) than those without (p < 0.001); QoL was worst among those with probable MOH (pMOH). Mean proportions of total available time spent in the ictal state were 5.4 % among participants with migraine, 3.9 % among those with TTH and 44.7 % among those with pMOH, with headache-related disabilities of 2.4, 0.15 and 9.7 % respectively. At population level, these disorders were responsible for reduced functional capacities of 0.81, 0.06 and 0.20 %. Total lost productive time due to headache was 6.8 % for the 85 % of the population with headache. Males lost more paid worktime than females (p < 0.001); the reverse was so for household worktime (p < 0.001). CONCLUSIONS: Headache disorders, very common in Nepal, are also highly burdensome at both individual and population levels. There is a substantial penalty in lost production. The remedy lies in better health care for headache; structured headache-care services are urgently needed in the country, and likely to be cost-saving. |
format | Online Article Text |
id | pubmed-4726638 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-47266382016-02-03 The burden of headache disorders in Nepal: estimates from a population-based survey Manandhar, Kedar Risal, Ajay Linde, Mattias Steiner, Timothy J. J Headache Pain Research Article BACKGROUND: Headache disorders, particularly migraine and tension-type headache (TTH), are among the most prevalent global public-health problems. Medication-overuse headache (MOH) is a common sequela of mismanagement of these. Migraine and MOH are highly disabling. Formulation of responsive health policy requires reliable, locally-derived, population-based data describing both individual and societal impact of headache disorders. South-East Asia is the only one of WHO’s six world regions in which no such national data have yet been gathered. METHODS: In a nationwide population-based cross-sectional study, a representative sample of Nepalese-speaking adults (18–65 years) were randomly selected by stratified multistage cluster sampling. Trained interviewers made unannounced door-to-door visits and enquired into headache and its attributable burden using a culturally-adapted and validated Nepalese translation of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire. RESULTS: Among 2100 participants, 1794 (85.4 %) reported headache during the preceding year (male: 689 [38.4 %], female 1105 [61.6 %]; mean age 36.1 ± 12.6 years). Mean headache frequency was 3.8 ± 6.2 days/month, mean headache intensity 2.1 ± 0.7 on a 0–3 scale, and mean attack duration 41.9 ± 108.5 h. All aspects of symptom burden (frequency, intensity and duration) were greater among females (p < 0.001). Participants with headache had poorer quality of life (QoL) than those without (p < 0.001); QoL was worst among those with probable MOH (pMOH). Mean proportions of total available time spent in the ictal state were 5.4 % among participants with migraine, 3.9 % among those with TTH and 44.7 % among those with pMOH, with headache-related disabilities of 2.4, 0.15 and 9.7 % respectively. At population level, these disorders were responsible for reduced functional capacities of 0.81, 0.06 and 0.20 %. Total lost productive time due to headache was 6.8 % for the 85 % of the population with headache. Males lost more paid worktime than females (p < 0.001); the reverse was so for household worktime (p < 0.001). CONCLUSIONS: Headache disorders, very common in Nepal, are also highly burdensome at both individual and population levels. There is a substantial penalty in lost production. The remedy lies in better health care for headache; structured headache-care services are urgently needed in the country, and likely to be cost-saving. Springer Milan 2016-01-25 /pmc/articles/PMC4726638/ /pubmed/26810487 http://dx.doi.org/10.1186/s10194-016-0594-0 Text en © Manandhar et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Article Manandhar, Kedar Risal, Ajay Linde, Mattias Steiner, Timothy J. The burden of headache disorders in Nepal: estimates from a population-based survey |
title | The burden of headache disorders in Nepal: estimates from a population-based survey |
title_full | The burden of headache disorders in Nepal: estimates from a population-based survey |
title_fullStr | The burden of headache disorders in Nepal: estimates from a population-based survey |
title_full_unstemmed | The burden of headache disorders in Nepal: estimates from a population-based survey |
title_short | The burden of headache disorders in Nepal: estimates from a population-based survey |
title_sort | burden of headache disorders in nepal: estimates from a population-based survey |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4726638/ https://www.ncbi.nlm.nih.gov/pubmed/26810487 http://dx.doi.org/10.1186/s10194-016-0594-0 |
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