Health  Vol.10 No.10 , October 2018
Prevalence and Pattern of Migraine, Tension Type Headache and Chronic Daily Headache among Medical and Nursing Students in Enugu, South East Nigeria
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.
References
[1]   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.

[2]   Ogunyemi, A.O. (1984) Prevalence of Headache among Nigerian University Students. Headache: The Journal of Head and Face Pain, 24, 127-130.
https://doi.org/10.1111/j.1526-4610.1984.hed2403127.x

[3]   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

[4]   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.

[5]   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.

[6]   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.
https://doi.org/10.1186/1746-160X-10-48

[7]   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

[8]   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.

[9]   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.
https://doi.org/10.1159/000110687

[10]   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.

[11]   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.

[12]   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.

[13]   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

[14]   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.
https://doi.org/10.1111/j.1526-4610.2010.01776.x

[15]   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.
https://doi.org/10.1111/j.1468-2982.2007.01288.x

[16]   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.
https://doi.org/10.1046/j.1468-2982.1995.1506482.x

[17]   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.
https://doi.org/10.1186/s10194-015-0515-7

[18]   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

[19]   Castillo, J., Munoz, P., Guitera, V. and Pascual, J. (1999) Epidemiology of Chronic Daily Headache in the General Population. Headache, 39, 190-196.
https://doi.org/10.1046/j.1526-4610.1999.3903190.x

[20]   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

[21]   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

[22]   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

[23]   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

[24]   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.
https://doi.org/10.1111/j.1468-2982.2008.01670.x

[25]   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

[26]   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

[27]   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.

[28]   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.
https://doi.org/10.1007/s10194-006-0273-7

[29]   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.

[30]   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.
https://doi.org/10.1016/S0140-6736(07)61479-2

[31]   Headache Classification Committee of the International Headache Society (2013) The International Classification of Headache Disorders. Cephalalgia, 33, 629-808.

[32]   Dodick, D.W. (2006) Chronic Daily Headache. New England Journal of Medicine, 354, 158-165.
https://doi.org/10.1056/NEJMcp042897

[33]   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

[34]   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.
https://doi.org/10.1007/s10194-009-0122-6

[35]   Mathew, N.T. (2005) Chronic Daily Headache. In: Evans, R.W. and Matthew, N.T., Eds., Handbook Headache, Lippincott Williams & Wilkins, Philadelphia, 113-115.

[36]   World Health Organization (2004) Headache Disorders. Fact Sheet No. 277.

[37]   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

[38]   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.
https://doi.org/10.1186/1129-2377-14-40

[39]   Ahmed, F., Parthasarathy, R. and Modar, K. (2012) Chronic Daily Headaches. Annals of Indian Academy of Neurology, 15, S40-S50.
https://doi.org/10.4103/0972-2327.100002

 
 
Top