Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use data from the GBD 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-...
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Published in: | Lancet neurology Vol. 17; no. 11; pp. 954 - 976 |
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Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format: | Journal Article |
Language: | English |
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England
Elsevier Ltd
01-11-2018
Elsevier Limited Lancet Pub. Group |
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Abstract | Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use data from the GBD 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache and to present the methods and results in an accessible way for clinicians and researchers of headache disorders.
Data were derived from population-based cross-sectional surveys on migraine and tension-type headache. Prevalence for each sex and 5-year age group interval (ie, age 5 years to ≥95 years) at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Disease burden measured in YLDs was calculated from prevalence and average time spent with headache multiplied by disability weights (a measure of the relative severity of the disabling consequence of a disease). The burden stemming from medication overuse headache, which was included in earlier iterations of GBD as a separate cause, was subsumed as a sequela of either migraine or tension-type headache. Because no deaths were assigned to headaches as the underlying cause, YLDs equate to disability-adjusted life-years (DALYs). We also analysed results on the basis of the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility.
Almost three billion individuals were estimated to have a migraine or tension-type headache in 2016: 1·89 billion (95% uncertainty interval [UI] 1·71–2·10) with tension-type headache and 1·04 billion (95% UI 1·00–1·09) with migraine. However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45·1 million (95% UI 29·0–62·8) and tension-type headache only 7·2 million (95% UI 4·6–10·5) YLDs globally in 2016. The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20·3 million (95% UI 12·9–28·5) and tension-type headache 2·9 million (95% UI 1·8–4·2) YLDs in 2016, which was 11·2% of all YLDs in this age group and sex. Age-standardised DALYs for each headache type showed a small increase as SDI increased.
Although current estimates are based on limited data, our study shows that headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. Future iterations of this study, based on sources from additional countries and with less methodological heterogeneity, should help to provide stronger evidence of the need for action.
Bill & Melinda Gates Foundation. |
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AbstractList | Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use data from the GBD 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache and to present the methods and results in an accessible way for clinicians and researchers of headache disorders.
Data were derived from population-based cross-sectional surveys on migraine and tension-type headache. Prevalence for each sex and 5-year age group interval (ie, age 5 years to ≥95 years) at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Disease burden measured in YLDs was calculated from prevalence and average time spent with headache multiplied by disability weights (a measure of the relative severity of the disabling consequence of a disease). The burden stemming from medication overuse headache, which was included in earlier iterations of GBD as a separate cause, was subsumed as a sequela of either migraine or tension-type headache. Because no deaths were assigned to headaches as the underlying cause, YLDs equate to disability-adjusted life-years (DALYs). We also analysed results on the basis of the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility.
Almost three billion individuals were estimated to have a migraine or tension-type headache in 2016: 1·89 billion (95% uncertainty interval [UI] 1·71-2·10) with tension-type headache and 1·04 billion (95% UI 1·00-1·09) with migraine. However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45·1 million (95% UI 29·0-62·8) and tension-type headache only 7·2 million (95% UI 4·6-10·5) YLDs globally in 2016. The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20·3 million (95% UI 12·9-28·5) and tension-type headache 2·9 million (95% UI 1·8-4·2) YLDs in 2016, which was 11·2% of all YLDs in this age group and sex. Age-standardised DALYs for each headache type showed a small increase as SDI increased.
Although current estimates are based on limited data, our study shows that headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. Future iterations of this study, based on sources from additional countries and with less methodological heterogeneity, should help to provide stronger evidence of the need for action.
Bill & Melinda Gates Foundation. BACKGROUNDThrough the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use data from the GBD 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache and to present the methods and results in an accessible way for clinicians and researchers of headache disorders. METHODSData were derived from population-based cross-sectional surveys on migraine and tension-type headache. Prevalence for each sex and 5-year age group interval (ie, age 5 years to ≥95 years) at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Disease burden measured in YLDs was calculated from prevalence and average time spent with headache multiplied by disability weights (a measure of the relative severity of the disabling consequence of a disease). The burden stemming from medication overuse headache, which was included in earlier iterations of GBD as a separate cause, was subsumed as a sequela of either migraine or tension-type headache. Because no deaths were assigned to headaches as the underlying cause, YLDs equate to disability-adjusted life-years (DALYs). We also analysed results on the basis of the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility. FINDINGSAlmost three billion individuals were estimated to have a migraine or tension-type headache in 2016: 1·89 billion (95% uncertainty interval [UI] 1·71-2·10) with tension-type headache and 1·04 billion (95% UI 1·00-1·09) with migraine. However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45·1 million (95% UI 29·0-62·8) and tension-type headache only 7·2 million (95% UI 4·6-10·5) YLDs globally in 2016. The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20·3 million (95% UI 12·9-28·5) and tension-type headache 2·9 million (95% UI 1·8-4·2) YLDs in 2016, which was 11·2% of all YLDs in this age group and sex. Age-standardised DALYs for each headache type showed a small increase as SDI increased. INTERPRETATIONAlthough current estimates are based on limited data, our study shows that headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. Future iterations of this study, based on sources from additional countries and with less methodological heterogeneity, should help to provide stronger evidence of the need for action. FUNDINGBill & Melinda Gates Foundation. Summary Background Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use data from the GBD 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache and to present the methods and results in an accessible way for clinicians and researchers of headache disorders. Methods Data were derived from population-based cross-sectional surveys on migraine and tension-type headache. Prevalence for each sex and 5-year age group interval (ie, age 5 years to ≥95 years) at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Disease burden measured in YLDs was calculated from prevalence and average time spent with headache multiplied by disability weights (a measure of the relative severity of the disabling consequence of a disease). The burden stemming from medication overuse headache, which was included in earlier iterations of GBD as a separate cause, was subsumed as a sequela of either migraine or tension-type headache. Because no deaths were assigned to headaches as the underlying cause, YLDs equate to disability-adjusted life-years (DALYs). We also analysed results on the basis of the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility. Findings Almost three billion individuals were estimated to have a migraine or tension-type headache in 2016: 1·89 billion (95% uncertainty interval [UI] 1·71–2·10) with tension-type headache and 1·04 billion (95% UI 1·00–1·09) with migraine. However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45·1 million (95% UI 29·0–62·8) and tension-type headache only 7·2 million (95% UI 4·6–10·5) YLDs globally in 2016. The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20·3 million (95% UI 12·9–28·5) and tension-type headache 2·9 million (95% UI 1·8–4·2) YLDs in 2016, which was 11·2% of all YLDs in this age group and sex. Age-standardised DALYs for each headache type showed a small increase as SDI increased. Interpretation Although current estimates are based on limited data, our study shows that headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. Future iterations of this study, based on sources from additional countries and with less methodological heterogeneity, should help to provide stronger evidence of the need for action. Funding Bill & Melinda Gates Foundation. |
Author | Westerman, Ronny Khang, Young-Ho Smith, Mari Abdelalim, Ahmed Sawhney, Monika Shiferaw, Mekonnen Sisay Tran, Bach Xuan Barac, Aleksandra Nirayo, Yirga Legesse Doan, Linh Phuong Kokubo, Yoshihiro Santos, Itamar S Mohammed, Mohammed A weldegwergs, Kidu gidey Nichols, Emma Truong, Nu Thi Murray, Christopher J L Venketasubramanian, Narayanaswamy Feigin, Valery L Szoeke, Cassandra E I Roba, Kedir T Hilawe, Esayas Haregot Shiue, Ivy Steiner, Timothy J Edessa, Dumessa Wijeratne, Tissa Hankey, Graeme J Safiri, Saeid Bensenor, Isabela M Ansha, Mustafa Geleto Gankpe, Fortune Gbetoho Khalil, Ibrahim Hay, Simon I Hegazy, Mohamed I Moradi-Lakeh, Maziar Nguyen, Huong Lan Thi Ranta, Anna Stovner, Lars Jacob Abd-Allah, Foad Gopalkrishna, Gururaj Vos, Theo Foreman, Kyle J Satpathy, Maheswar Kasaeian, Amir Kim, Yun Jin Khubchandan, Jagdish Endres, Matthias Qorbani, Mostafa Al-Raddadi, Rajaa M Gupta, Rahul Kassa, Dessalegn H Mokdad, Ali H Goulart, Alessandra C Yonemoto, Naohiro |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30353868$$D View this record in MEDLINE/PubMed |
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Copyright | 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. Copyright Elsevier Limited Nov 2018 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 2018 |
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contributor: fullname: Jonsson – volume: 17 start-page: 24 year: 2016 ident: 10.1016/S1474-4422(18)30322-3_bib38 article-title: Structured education can improve primary-care management of headache: the first empirical evidence, from a controlled interventional study publication-title: J Headache Pain doi: 10.1186/s10194-016-0613-1 contributor: fullname: Braschinsky – volume: 36 start-page: 15 year: 2016 ident: 10.1016/S1474-4422(18)30322-3_bib30 article-title: Medication overuse, healthy lifestyle behaviour and stress in chronic headache: results from a population-based representative survey publication-title: Cephalalgia doi: 10.1177/0333102415578430 contributor: fullname: Westergaard – volume: 24 start-page: 1055 year: 2017 ident: 10.1016/S1474-4422(18)30322-3_bib32 article-title: Migraine associated with altitude: results from a population-based study in Nepal publication-title: Eur J Neurol doi: 10.1111/ene.13334 contributor: fullname: Linde |
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Snippet | Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use... Summary Background Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health... BACKGROUNDThrough the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We... |
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SubjectTerms | Adolescent Adult Age Age Distribution Aged Aged, 80 and over Bayes Theorem Bayesian analysis Child Child, Preschool Community Health Planning Cross-Sectional Studies Disabled Persons Disease Epidemiology Estimates Female Global Burden of Disease - methods Global Health Headache Headaches Humans Male Middle Aged Migraine Migraine Disorders - economics Migraine Disorders - epidemiology Mortality Prevalence Public health PubMed - statistics & numerical data Resource allocation Retrospective Studies Risk factors Studies Systematic review Tension-Type Headache - economics Tension-Type Headache - epidemiology Young Adult |
Title | Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 |
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