ABSTRACT Aim: To assess the lifetime prevalence of tension-type headache, migraine and chronic daily headache, including the primary headaches in a student population. Methods: This is a cross-sectional descriptive study. Data were collected from consecutive consenting students by means of a semi-structured questionnaire. The questionnaire was designed to assess demographic data, headache profiles and medical consultation. Results: Four hundred and forty-nine (89.8%) out of 500 students who were interviewed were analyzed. The lifetime prevalence of primary headache was 89.8%; it 90.5% and 88.6% in females and males respectively. The overall prevalence of migraine was 8.9%, with a prevalence of 10.6% in females and 6.5% in males. Migraine without aura was most commonly seen at 73%. The prevalence of migraine without aura was 7.6% in females and 4.9% in males. Tension type headache (TTH) had an overall prevalence of 22.9%, with a prevalence of 28.4% in females and 15.1% in males. Migraine and tension type headache co-existed in 5.8% of the students. About 8.5% suffered from chronic daily headache: chronic migraine 2.9%, chronic tension headache 3.1%. The rate of medical consultation was 54.8% (males 49.7%, females 58.3%). Conclusions: Headache is a common health problem among medical and nursing students in Enugu South East Nigeria where 89.8% of respondents have had primary headaches. The prevalence of migraine, TTH and chronic daily headache was 8.9%, 22.9% and 8.5% respectively. Headaches therefore, represent one of the most challenging neurological disorders in Sub-Saharan Africa where most sufferers do not have access to specialist care.
Cite this paper
Ekenze, O. , Ezeala-Adikaibe, B. , Orjioke, C. , Mbadiwe, N. , Ijoma, U. , Onyekonwu, C. , Ezeala-Adikaibe, N. , Onodugo, O. , Anyim, O. , Okpara, T. , Nwatu, C. and Onwuekwe, I. (2018) Prevalence and Pattern of Migraine, Tension Type Headache and Chronic Daily Headache among Medical and Nursing Students in Enugu, South East Nigeria. Health, 10, 1283-1293. doi: 10.4236/health.2018.1010099.
 Ezeala-Adikaibe, A.B., Ekenze, O.S., Onwuekwe, I.O. and Ulasi, I.I. (2012) Frequency and Pattern of Headache among Medical Students at Enugu, South East Nigeria. Nigerian Journal of Medicine, 21, 205-208.
 Ogunyemi, A.O. (1984) Prevalence of Headache among Nigerian University Students. Headache: The Journal of Head and Face Pain, 24, 127-130.
 Kolawole, W.W. and Asuwemhe, J.U. (2009) Migraine: Prevalence and Associated Disability among Nigerian Undergraduates. Canadian Journal of Neurological Sciences, 36, 216-221. https://doi.org/10.1017/S0317167100006570
 Onwuekwe, I.O., Ezeala-Adikaibe, B.A. and Ekenze, O.S. (2012) Neurological Disease Burden in Two Semi-Urban Communities in South East Nigeria. Nigerian Journal of Medicine, 21, 317-319.
 Onwuekwe, I.O. and Ezeala-Adikaibe, B. (2011) Prevalence and Distribution of Neurological Disease in a Neurology Clinic in Enugu, Nigeria. Annals of Medical and Health Science Research, 1, 63-67.
 Onwuekwe, I.O., Onyeka, T., Aguwa, E., Ezeala-Adikaibe, B., Ekenze, O. and Onuora, E. (2014) Headache Prevalence and Its Characterization amongst Hospital Workers in Enugu, South East Nigeria. Head & Face Medicine, 10, 48.
 Ojini, F.I., Okubadejo, N.U. and Danesi, M.A. (2009) Prevalence and Clinical Characteristics of Headache in Medical Students of the University of Lagos, Nigeria. Cephalagia, 29, 472-477. https://doi.org/10.1111/j.1468-2982.2008.01766.x
 Oshinaike, O., Ojo, O., Okubadejo, N., Ojelabi, O. and Dada, A. (2014) Primary Headache Disorders at a Tertiary Health Facility in Lagos, Nigeria: Prevalence and Consultation Patterns. Biomed Research International, Article ID: 782915.
 Osuntokun, B., Schoenberg, B., Nottidge, V., Adeuja, A., Kale, O., Adeyefa, A., Bademosi, O. and Bolis, C.L. (1982) Migraine Headache in a Rural Community in Nigeria: Results of a Pilot Study. Neuroepidemiology, 1, 31-39.
 Longe, A.C. and Osuntokun, B.O. (1988) Prevalence of Neurological Disorders in Udo, a Rural Community in Southern Nigeria. Tropical and Geographical Medicine, 65, 36-40.
 Osuntokun, B.O., Adeuja, A.O., Nottidge, V.A., Bademosi, O., Alumide, A.O., Ige, O., Yarai, F., Scoenberg, B.S. and Bolis, C.L. (1992) Prevalence of Headache and Migrainous Headache in Nigerian Africans: A Community-Based Study. East African Medical Journal, 69, 196-199.
 Orji, G.I. and Iloeje, S.O. (1997) Childhood Migraine in Nigeria—I: A Community-Based Study. West African Journal of Medicine, 16, 208-217.
 Ezeala-Adikaibe, B.A., Onyekonwu, C., Okudo, G., Onodugo, O., Ekenze, S., Orjioke, C., Chime, P., Ezeanosike, O., Mbadiwe, N., Chikani, M., Okwara, C., Ulasi, I. and Ijoma, U. (2014) Prevalence of Primary Headaches in an Urban Slum in Enugu South East Nigeria: A Door-to-Door Survey. Headache: The Journal of Head and Face Pain, 54, 1601-1610. https://doi.org/10.1111/head.12465
 Ofovwem, G.F. and Ofili, A.N. (2010) Prevalence and Impact of Headache and Migraine among Secondary School Students in Nigeria. Headache: The Journal of Head and Face Pain, 50, 1570-1575.
 Stovner, L.J., Hagen, K., Jensen, R., Katsarava, Z., Lipton, R.B., Scher, A.I., Steiner, T. and Zwart, J.A. (2007) The Global Burden of Headache: A Documentation of Headache Prevalence and Disability Worldwide. Cephalalgia, 27, 193-210.
 Haimanot, T.R., Seraw, B., Forsgren, L., Ekbom, K. and Ekstedt, J. (1995) Migraine, Chronic Tension-Type Headache, and Cluster Headache in an Ethiopian Rural Community. Cephalagia, 15, 482-488.
 Mbewe, E., Zairemthiama, P., Yeh, H., Paul, R., Birbeck, G.L. and Steiner, T.J. (2015) The Epidemiology of Primary Headache Disorders in Zambia: A Population-Based Door-to-Door Survey. Journal of Headache and Pain, 16, 30.
 Lu, S.R., Fuh, J.L., Chen, W.T., Juang, K.D. and Wang, S.J. (2001) Chronic Daily Headache in Taipei, Taiwan: Prevalence, Follow-Up, and Outcome Predictors. Cephalalgia, 21, 980-986. https://doi.org/10.1046/j.1468-2982.2001.00294.x
 Castillo, J., Munoz, P., Guitera, V. and Pascual, J. (1999) Epidemiology of Chronic Daily Headache in the General Population. Headache, 39, 190-196.
 Scher, A.I., Stewart, W.F., Ricci, J.A. and Lipton, R.B. (2003) Factors Associated with the Onset and Remission of Chronic Daily Headache in a Population Based Study. Pain, 106, 81-89. https://doi.org/10.1016/S0304-3959(03)00293-8
 Prencipe, M., Casini, A.R., Ferretti, C., Santini, M., Pezzella, F., Scaldaferri, N. and Culasso, F. (2001) Prevalence of Headache in an Elderly Population: Attack Frequency, Disability, and Use of Medication. Journal of Neurology, Neurosurery and Psychiatry, 70, 377-381. https://doi.org/10.1136/jnnp.70.3.377
 Wang, S.J., Fuh, J.L., Lu, S.R., Liu, C.Y., Wang, P.N. and Liu, H.C. (2000) Chronic Daily Headache in Chinese Elderly: Prevalence, Risk Factors, and Biannual Follow-Up. Neurology, 54, 314-319. https://doi.org/10.1212/WNL.54.2.314
 Katsarava, Z., Dzagnidze, A., Kukava, M., Mirvelashvili, E., Djibuti, M., Janelidze, M., Jensen, R., Stovener, L.J. and Steiner, T.J. (2009) Lifting the Burden: The Global Campaign to Reduce the Burden of Headache Worldwide and the Russian Linquistic Subcommittee of the International Headache Society. Primary Headache Disorders in the Republic of Georgia: Prevalence and Risk Factors. Neurology, 73, 1796-1803. https://doi.org/10.1212/WNL.0b013e3181c34abb
 Queiroz, L.P., Peres, M.F., Kowacs, F., Piovesan, E.J., Ciciarelli, M.C., Souza, J.A. and Zukerman, E. (2008) Chronic Daily Headache in Brazil: A Nationwide Population Based Study. Cephalalgia, 28, 1264-1269.
 D’Amico, D., Grazzim, L., Usai, S., Raggi, A., Leonardi, M. and Bussone, G. (2011) Disability in Chronic Daily Headache: State of the Art and Future Directions. Neurological Sciences, 32, S71-S76. https://doi.org/10.1007/s10072-011-0552-1
 Munakata, J., Hazard, E., Serrano, D., Klingman, D., Rupnow, M.F.T., Tierce, J., Reed, M. and Lipton, R.B. (2009) Economic Burden of Transformed Migraine: Results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache, 49, 498-508. https://doi.org/10.1111/j.1526-4610.2009.01369.x
 Steiner T. Atlas of Headache Disorders and Resources (2011) A Collaborative Study by the World Health Organization and Lifting the Burden. A Product of the Global Campaign against Headache. World Health Organization.
 Karli, N., Zarifoglu, M., Ertas, M., Saip, S., Oztürk, V. and Bicakci, S. ((2006) Economic Impact of Primary Headaches in Turkey: A University Hospital-Based Study: Part II. Journal of Headache and Pain, 7, 75-82.
 Timothy, S.Y., Mava, Y. and Bwala, A.Y. (2012) Impact of Acute Migraine Headache amongst University Students in Northeastern Nigeria. International Research Journal of Pharmacy, 3, 134-136.
 Patel, V., Simbine, A.P., Soares, I.C., Weisss, H.A. and Wheeler, E. (2007) Prevalence of Severe Mental and Neurological Disorders in Mozambique: A Population-Based Survey. The Lancet, 370, 1055-1060.
 Headache Classification Committee of the International Headache Society (2013) The International Classification of Headache Disorders. Cephalalgia, 33, 629-808.
 Dodick, D.W. (2006) Chronic Daily Headache. New England Journal of Medicine, 354, 158-165. https://doi.org/10.1056/NEJMcp042897
 Amayo, E.O., Jowi, J.O. and Njeru, E.K. (2002) Headache Associated Disability in Medical Students at the Kenyatta National Hospital, Nairobi. East African Medical Journal, 79, 519-523. https://doi.org/10.4314/eamj.v79i10.8813
 Alzoubi, K.H., Mhaidat, N., Al Azzam, S., Khader, Y., Salem, S., Issaifan, H. and Haddadin, R. (2009) Prevalence of Migraine and Tension-Type Headache among Adults in Jordan. Journal of Headache and Pain, 10, 265-270.
 Mathew, N.T. (2005) Chronic Daily Headache. In: Evans, R.W. and Matthew, N.T., Eds., Handbook Headache, Lippincott Williams & Wilkins, Philadelphia, 113-115.
 World Health Organization (2004) Headache Disorders. Fact Sheet No. 277.
 Ulrich, V., Russel, M.B., Jensen, R. and Olesen, J. (1996) A Comparison of Tension-Type Headache in Migraineurs and in Non-Migraineurs: A Population-Based Study. Pain, 67, 501-506. https://doi.org/10.1016/0304-3959(96)03164-8
 Schramm, S.H., Obermann, M., Katsarava, Z., Diener, H., Moebus, S. and Yoon, M. (2013) Epidemiological Profiles of Patients with Chronic Migraine and Chronic tension-Type Headache. Journal of Headache and Pain, 14, 40.
 Ahmed, F., Parthasarathy, R. and Modar, K. (2012) Chronic Daily Headaches. Annals of Indian Academy of Neurology, 15, S40-S50.