The prevalence of headache in the adult population of Morocco: a cross-sectional population-based study
Background The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very dif...
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| Published in: | Journal of headache and pain Vol. 25; no. 1; pp. 49 - 9 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Springer Milan
03-04-2024
Springer Nature B.V BMC |
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| Abstract | Background
The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco.
Methods
We applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18–65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation.
Results
We included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+.
Conclusions
While the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache. |
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| AbstractList | BackgroundThe series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco.MethodsWe applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18–65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation.ResultsWe included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+.ConclusionsWhile the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache. The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco. We applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18-65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation. We included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+. While the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache. Background The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco. Methods We applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18–65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation. Results We included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+. Conclusions While the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache. The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco.BACKGROUNDThe series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco.We applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18-65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation.METHODSWe applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18-65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation.We included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+.RESULTSWe included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+.While the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache.CONCLUSIONSWhile the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache. Abstract Background The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco. Methods We applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18–65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation. Results We included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+. Conclusions While the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache. |
| ArticleNumber | 49 |
| Author | Kissani, Najib Sidibe, Aboubacar Sidik Steiner, Timothy J Thomas, Hallie Garmane, Abderrahmane Chraa, Mohamed Adarmouch, Latifa Founoun, Rachid Husøy, Andreas |
| Author_xml | – sequence: 1 givenname: Najib surname: Kissani fullname: Kissani, Najib organization: Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Cadi Ayyad University, Department of Neurology, Mohammed VI University Hospital – sequence: 2 givenname: Latifa surname: Adarmouch fullname: Adarmouch, Latifa organization: Community Medicine and Public Health Department, Bioscience and Health Research Laboratory, Faculty of Medicine, Cadi Ayyad University – sequence: 3 givenname: Aboubacar Sidik surname: Sidibe fullname: Sidibe, Aboubacar Sidik organization: Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Cadi Ayyad University – sequence: 4 givenname: Abderrahmane surname: Garmane fullname: Garmane, Abderrahmane organization: Marrakech Medical School – sequence: 5 givenname: Rachid surname: Founoun fullname: Founoun, Rachid organization: Marrakech Medical School – sequence: 6 givenname: Mohamed surname: Chraa fullname: Chraa, Mohamed organization: Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Cadi Ayyad University – sequence: 7 givenname: Hallie surname: Thomas fullname: Thomas, Hallie organization: Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology – sequence: 8 givenname: Andreas surname: Husøy fullname: Husøy, Andreas organization: Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology – sequence: 9 givenname: Timothy J surname: Steiner fullname: Steiner, Timothy J email: t.steiner@imperial.ac.uk organization: Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Department of Neurology, University of Copenhagen, Division of Brain Sciences, Imperial College London |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38565983$$D View this record in MEDLINE/PubMed |
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| Keywords | Headache Medication-overuse headache Tension-type headache Prevalence Morocco Migraine Population-based study Maghreb Eastern Mediterranean Region Global Campaign against Headache Epidemiology |
| Language | English |
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| PublicationSubtitle | Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache" |
| PublicationTitle | Journal of headache and pain |
| PublicationTitleAbbrev | J Headache Pain |
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| References | Manandhar, Risal, Steiner, Holen, Linde (CR16) 2015; 16 Yu, Cao, Zhao, Yang, Qiao, Fang (CR23) 2011; 12 Steiner, Stovner (CR20) 2023; 19 (CR12) 2013; 310 Herekar, Ahmad, Uqaili, Ahmed, Effendi, Alvi (CR5) 2017; 18 CR14 CR13 Steiner, Gururaj, Andrée, Katsarava, Ayzenberg, Yu (CR11) 2014; 15 Stovner, Al Jumah, Birbeck, Gururaj, Jensen, Katsarava (CR10) 2014; 15 Stovner, Hagen, Linde, Steiner (CR1) 2022; 23 Ayzenberg, Katsarava, Sborowski, Chernysh, Osipova, Tabeeva (CR17) 2012; 32 Jakuš, Mahović, Steiner (CR26) 2022; 63 Vos (CR3) 2020; 396 May, Schulte (CR15) 2016; 12 Yu, Liu, Zhao, Yang, Qiao, Feng (CR21) 2012; 52 Herekar, Herekar, Ahmad, Uqaili, Ahmed, Effendi (CR22) 2013; 14 Duggal, Chowdhury, Krishnan, Amarchand, Steiner (CR27) 2024; 25 CR4 CR8 CR7 Andrée, Stovner, Steiner, Barré, Katsarava, Lainez, Lanteri-Minet, Mick, Rastenyte, de la Ruiz, Tassorelli, Vriezen, Lampl (CR28) 2011; 12 CR9 Steiner, Birbeck, Jensen, Martelletti, Stovner, Uluduz (CR2) 2022; 23 Al Jumah, Al Khathaami, Kojan, Hussain, Thomas, Steiner (CR6) 2020; 21 Luvsannorov, Tsenddorj, Baldorj, Enkhtuya, Purev, Thomas (CR18) 2019; 20 Rao, Kulkarni, Gururaj, Rajesh, Subbakrishna, Steiner (CR25) 2012; 13 Mbewe, Zairemthiama, Yeh, Paul, Birbeck, Steiner (CR19) 2015; 16 Ayzenberg, Katsarava, Mathalikov, Chernysh, Osipova, Tabeeva (CR24) 2011; 18 AD Herekar (1761_CR22) 2013; 14 TJ Steiner (1761_CR2) 2022; 23 M Al Jumah (1761_CR6) 2020; 21 I Ayzenberg (1761_CR17) 2012; 32 T Vos (1761_CR3) 2020; 396 AA Herekar (1761_CR5) 2017; 18 LJ Stovner (1761_CR10) 2014; 15 C Andrée (1761_CR28) 2011; 12 1761_CR4 1761_CR9 TJ Steiner (1761_CR11) 2014; 15 A May (1761_CR15) 2016; 12 L Jakuš (1761_CR26) 2022; 63 1761_CR7 1761_CR8 A Duggal (1761_CR27) 2024; 25 World Medical Association (1761_CR12) 2013; 310 O Luvsannorov (1761_CR18) 2019; 20 SY Yu (1761_CR23) 2011; 12 1761_CR13 TJ Steiner (1761_CR20) 2023; 19 1761_CR14 LJ Stovner (1761_CR1) 2022; 23 GN Rao (1761_CR25) 2012; 13 I Ayzenberg (1761_CR24) 2011; 18 E Mbewe (1761_CR19) 2015; 16 S Yu (1761_CR21) 2012; 52 K Manandhar (1761_CR16) 2015; 16 |
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The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the... The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern... BackgroundThe series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the... Abstract Background The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia... |
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| SubjectTerms | Adult Aged Cross-Sectional Studies Epidemiology Female Females Headache Headache - epidemiology Headache Disorders, Primary - diagnosis Headache Disorders, Secondary - epidemiology Headaches Humans Internal Medicine Male Medicine Medicine & Public Health Middle Aged Migraine Migraine Disorders - epidemiology Morocco - epidemiology Neurology Pain Medicine Population studies Population-based studies Population-based study Prevalence Questionnaires Sampling Tension-type headache Young Adult |
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| Title | The prevalence of headache in the adult population of Morocco: a cross-sectional population-based study |
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