The burden of headache disorders in Nepal: estimates from a population-based survey

被引:0
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作者
Manandhar, Kedar [1 ,2 ]
Risal, Ajay [1 ,2 ]
Linde, Mattias [1 ,3 ]
Steiner, Timothy J. [1 ,4 ]
机构
[1] Norwegian Univ Sci & Technol, Dept Neurosci, NO-7489 Trondheim, Norway
[2] Kathmandu Univ Hosp, Dhulikhel Hosp, Kavre, Dhulikhel, Nepal
[3] St Olavs Univ Hosp, Norwegian Advisory Unit Headache, Trondheim, Norway
[4] Univ London Imperial Coll Sci Technol & Med, Div Brain Sci, London, England
来源
关键词
Migraine; Tension-type headache; Medication-overuse headache; Public health; Population-based study; Burden of disease; Disability; Nepal; South-East Asia region; Global campaign against headache; WILLINGNESS-TO-PAY; HEALTH-CARE; MAJOR DISORDERS; GLOBAL BURDEN; PREVALENCE; DISABILITY; COST; RECOMMENDATIONS; EPIDEMIOLOGY; METHODOLOGY;
D O I
10.1186/s10194-016-0594-0
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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.
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页码:1 / 10
页数:10
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