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Semin Neurol 2018; 38(02): 182-190
DOI: 10.1055/s-0038-1646946
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Global Burden of Headache

Deanna Saylor
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Timothy J. Steiner
2   Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
3   Division of Brain Sciences, Imperial College London, London, United Kingdom
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Further Information

Publication History

Publication Date:
23 May 2018 (online)

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Abstract

At the turn of the century, most of the world's population lived in regions where the prevalence of headache was unknown and its impact poorly understood. Lifting The Burden (LTB), a nonprofit organization in official relations with the World Health Organization, established the Global Campaign against Headache, with the ultimate purpose of reducing the burden of headache worldwide. First, the scope and scale of this burden had to be known. LTB embarked upon a program of population-based studies in countries in all world regions in order to achieve its aim. Its studies have demonstrated a high prevalence of headache disorders, including migraine, tension-type headache, and medication-overuse headache, and their associations with impaired quality of life, substantial lost productivity, and high economic costs in every country surveyed. Informed by these, the Global Burden of Disease study ranks headache disorders as the second leading cause of years lived with disability worldwide; migraine alone is third among people aged 15 to 49 years. With interventions urgently needed to reduce these burdens throughout the world, we review the epidemiological studies conducted by LTB, examine proposed interventions to improve provision of headache care including a three-tier system of structured headache services, and consider the challenges still remaining in providing effective, efficient, and equitable headache care especially in low-income countries.

Keywords

headache - migraine - tension-type headache - medication-overuse headache - burden of disease - intervention - structured headache services - global campaign against headache
 

  • References

  • 1 Stovner Lj, Hagen K, Jensen R. , et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007; 27 (03) 193-210
    CrossrefPubMedSearch in Google Scholar
  • 2 Vos T, Flaxman AD, Naghavi M. , et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380 (9859): 2163-2196
    CrossrefPubMedSearch in Google Scholar
  • 3 GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388 (10053): 1603-1658
    CrossrefPubMedSearch in Google Scholar
  • 4 GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388 (10053): 1545-1602
    CrossrefPubMedSearch in Google Scholar
  • 5 Steiner TJ, Birbeck GL, Jensen RH, Katsarava Z, Stovner LJ, Martelletti P. Headache disorders are third cause of disability worldwide. J Headache Pain 2015; 16: 58
    CrossrefPubMedSearch in Google Scholar
  • 6 Steiner TJ. Lifting The Burden: the global campaign to reduce the burden of headache worldwide. J Headache Pain 2005; 6 (05) 373-377
    CrossrefPubMedSearch in Google Scholar
  • 7 Steiner TJ. ; World Headache Alliance. Lifting the burden: the global campaign against headache. Lancet Neurol 2004; 3 (04) 204-205
    CrossrefPubMedSearch in Google Scholar
  • 8 Steiner TJ, Birbeck GL, Jensen R, Katsarava Z, Martelletti P, Stovner LJ. The Global Campaign, World Health Organization and Lifting The Burden: collaboration in action. J Headache Pain 2011; 12 (03) 273-274
    CrossrefPubMedSearch in Google Scholar
  • 9 Steiner TJ, Stovner LJ, Al Jumah M. , et al. Improving quality in population surveys of headache prevalence, burden and cost: key methodological considerations. J Headache Pain 2013; 14: 87
    CrossrefPubMedSearch in Google Scholar
  • 10 Stovner LJ, Al Jumah M, Birbeck GL. , et al. The methodology of population surveys of headache prevalence, burden and cost: principles and recommendations from the Global Campaign against Headache. J Headache Pain 2014; 15: 5
    CrossrefPubMedSearch in Google Scholar
  • 11 Steiner TJ, Gururaj G, Andrée C. , et al. Diagnosis, prevalence estimation and burden measurement in population surveys of headache: presenting the HARDSHIP questionnaire. J Headache Pain 2014; 15: 3
    CrossrefPubMedSearch in Google Scholar
  • 12 Wöber-Bingöl Ç, Wöber C, Uluduz D. , et al. The global burden of headache in children and adolescents - developing a questionnaire and methodology for a global study. J Headache Pain 2014; 15: 86
    CrossrefPubMedSearch in Google Scholar
  • 13 Ayzenberg I, Katsarava Z, Mathalikov R. , et al; Lifting The Burden: Global Campaign to Reduce Burden of Headache Worldwide and Russian Linguistic Subcommittee of International Headache Society. The burden of headache in Russia: validation of the diagnostic questionnaire in a population-based sample. Eur J Neurol 2011; 18 (03) 454-459
    CrossrefPubMedSearch in Google Scholar
  • 14 Al Jumah M, Al Khathaami A, Tamim H. , et al. HURT (Headache Under-Response to Treatment) questionnaire in the management of primary headache disorders: reliability, validity and clinical utility of the Arabic version. J Headache Pain 2013; 14: 16
    CrossrefPubMedSearch in Google Scholar
  • 15 Buse DC, Sollars CM, Steiner TJ, Jensen RH, Al Jumah MA, Lipton RB. Why HURT? A review of clinical instruments for headache management. Curr Pain Headache Rep 2012; 16 (03) 237-254
    CrossrefPubMedSearch in Google Scholar
  • 16 Westergaard ML, Steiner TJ, MacGregor EA. , et al. The Headache Under-Response to Treatment (HURT) Questionnaire: assessment of utility in headache specialist care. Cephalalgia 2013; 33 (04) 245-255
    CrossrefPubMedSearch in Google Scholar
  • 17 Katsarava Z, Dzagnidze A, Kukava M. , et al; Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide and the Russian Linguistic Subcommittee of the International Headache Society. Primary headache disorders in the Republic of Georgia: prevalence and risk factors. Neurology 2009; 73 (21) 1796-1803
    CrossrefPubMedSearch in Google Scholar
  • 18 Moldovanu I, Pavlic G, Odobescu S. , et al. The prevalence of headache disorders in the Republic of Moldova: a population-based study. Cephalalgia 2007; 27: 673
    PubMedSearch in Google Scholar
  • 19 Rastenytė D, Mickevičienė D, Stovner LJ, Thomas H, Andrée C, Steiner TJ. Prevalence and burden of headache disorders in Lithuania and their public-health and policy implications: a population-based study within the Eurolight Project. J Headache Pain 2017; 18 (01) 53
    CrossrefPubMedSearch in Google Scholar
  • 20 Ayzenberg I, Katsarava Z, Sborowski A. , et al; Lifting the Burden. The prevalence of primary headache disorders in Russia: a countrywide survey. Cephalalgia 2012; 32 (05) 373-381
    CrossrefPubMedSearch in Google Scholar
  • 21 Yu S, Liu R, Zhao G. , et al. The prevalence and burden of primary headaches in China: a population-based door-to-door survey. Headache 2012; 52 (04) 582-591
    CrossrefPubMedSearch in Google Scholar
  • 22 Kulkarni GB, Rao GN, Gururaj G, Stovner LJ, Steiner TJ. Headache disorders and public ill-health in India: prevalence estimates in Karnataka State. J Headache Pain 2015; 16: 67
    CrossrefPubMedSearch in Google Scholar
  • 23 Manandhar K, Risal A, Steiner TJ, Holen A, Linde M. The prevalence of primary headache disorders in Nepal: a nationwide population-based study. J Headache Pain 2015; 16: 95
    CrossrefPubMedSearch in Google Scholar
  • 24 Herekar AA, Ahmad A, Uqaili UL. , et al. Primary headache disorders in the adult general population of Pakistan - a cross sectional nationwide prevalence survey. J Headache Pain 2017; 18 (01) 28
    CrossrefPubMedSearch in Google Scholar
  • 25 Mbewe E, Zairemthiama P, Yeh HH, Paul R, Birbeck GL, Steiner TJ. The epidemiology of primary headache disorders in Zambia: a population-based door-to-door survey. J Headache Pain 2015; 16: 515
    PubMedSearch in Google Scholar
  • 26 Zebenigus M, Tekle-Haimanot R, Worku DK, Thomas H, Steiner TJ. The prevalence of primary headache disorders in Ethiopia. J Headache Pain 2016; 17 (01) 110
    CrossrefPubMedSearch in Google Scholar
  • 27 Steiner TJ, Stovner LJ, Katsarava Z. , et al. The impact of headache in Europe: principal results of the Eurolight project. J Headache Pain 2014; 15: 31
    CrossrefPubMedSearch in Google Scholar
  • 28 Steiner TJ, Stovner LJ, Vos T. GBD 2015: migraine is the third cause of disability in under 50s. J Headache Pain 2016; 17 (01) 104
    CrossrefPubMedSearch in Google Scholar
  • 29 World Health Organization. Atlas of Headache Disorders and Resources in the World: 2011. Geneva: WHO; 2011
    Search in Google Scholar
  • 30 Lampl C, Steiner TJ, Mueller T. , et al; Global Campaign against Headache; International Headache Society Russian Linguistic Special Interest Group. Will (or can) people pay for headache care in a poor country?. J Headache Pain 2012; 13 (01) 67-74
    CrossrefPubMedSearch in Google Scholar
  • 31 Ayzenberg I, Katsarava Z, Sborowski A. , et al. Headache-attributed burden and its impact on productivity and quality of life in Russia: structured healthcare for headache is urgently needed. Eur J Neurol 2014; 21 (05) 758-765
    CrossrefPubMedSearch in Google Scholar
  • 32 Andrée C, Stovner LJ, Steiner TJ. , et al. The Eurolight project: the impact of primary headache disorders in Europe. Description of methods. J Headache Pain 2011; 12 (05) 541-549
    CrossrefPubMedSearch in Google Scholar
  • 33 Lampl C, Thomas H, Stovner LJ. , et al. Interictal burden attributable to episodic headache: findings from the Eurolight project. J Headache Pain 2016; 17: 9
    CrossrefPubMedSearch in Google Scholar
  • 34 Lampl C, Thomas H, Tassorelli C. , et al. Headache, depression and anxiety: associations in the Eurolight project. J Headache Pain 2016; 17: 59
    CrossrefPubMedSearch in Google Scholar
  • 35 Yu S, He M, Liu R. , et al. Headache yesterday in China: a new approach to estimating the burden of headache, applied in a general-population survey in China. Cephalalgia 2013; 33 (15) 1211-1217
    CrossrefPubMedSearch in Google Scholar
  • 36 Rao GN, Kulkarni GB, Gururaj G, Stovner LJ, Steiner TJ. The burden attributable to headache disorders in India: estimates from a community-based study in Karnataka State. J Headache Pain 2015; 16: 94
    CrossrefPubMedSearch in Google Scholar
  • 37 Steiner TJ, Rao GN, Kulkarni GB, Gururaj G, Stovner LJ. Headache yesterday in Karnataka state, India: prevalence, impact and cost. J Headache Pain 2016; 17 (01) 74
    CrossrefPubMedSearch in Google Scholar
  • 38 Manandhar K, Risal A, Linde M, Steiner TJ. The burden of headache disorders in Nepal: estimates from a population-based survey. J Headache Pain 2015; 17: 3
    CrossrefPubMedSearch in Google Scholar
  • 39 Risal A, Manandhar K, Holen A, Steiner TJ, Linde M. Comorbidities of psychiatric and headache disorders in Nepal: implications from a nationwide population-based study. J Headache Pain 2016; 17: 45
    CrossrefPubMedSearch in Google Scholar
  • 40 Zebenigus M, Tekle-Haimanot R, Worku DK, Thomas H, Steiner TJ. The burden of headache disorders in Ethiopia: national estimates from a population-based door-to-door survey. J Headache Pain 2017; 18 (01) 58
    CrossrefPubMedSearch in Google Scholar
  • 41 Mbewe E, Zairemthiama P, Paul R, Birbeck GL, Steiner TJ. The burden of primary headache disorders in Zambia: national estimates from a population-based door-to-door survey. J Headache Pain 2015; 16: 513
    PubMedSearch in Google Scholar
  • 42 Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001; 41 (07) 646-657
    CrossrefPubMedSearch in Google Scholar
  • 43 Schwartz BS, Stewart WF, Simon D, Lipton RB. Epidemiology of tension-type headache. JAMA 1998; 279 (05) 381-383
    CrossrefPubMedSearch in Google Scholar
  • 44 Scher AI, Stewart WF, Liberman J, Lipton RB. Prevalence of frequent headache in a population sample. Headache 1998; 38 (07) 497-506
    CrossrefPubMedSearch in Google Scholar
  • 45 Messali A, Sanderson JC, Blumenfeld AM. , et al. Direct and indirect costs of chronic and episodic migraine in the United States: a web-based survey. Headache 2016; 56 (02) 306-322
    CrossrefPubMedSearch in Google Scholar
  • 46 Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386 (9995): 743-800
    CrossrefPubMedSearch in Google Scholar
  • 47 Brandes JL. Global trends in migraine care: results from the MAZE survey. CNS Drugs 2002; 16 (Suppl. 01) 13-18
    CrossrefPubMedSearch in Google Scholar
  • 48 Liu R, Yu S, He M. , et al. Health-care utilization for primary headache disorders in China: a population-based door-to-door survey. J Headache Pain 2013; 14: 47
    CrossrefPubMedSearch in Google Scholar
  • 49 Steiner TJ, Antonaci F, Jensen R, Lainez MJA, Lanteri-Minet M, Valade D. ; European Headache Federation; Global Campaign againist Headache. Recommendations for headache service organisation and delivery in Europe. J Headache Pain 2011; 12 (04) 419-426
    CrossrefPubMedSearch in Google Scholar
  • 50 van den Berg JSP, Steiner TJ, Veenstra PJL, Kollen BJ. Migraine nurses in primary care: costs and benefits. Headache 2017; 57 (08) 1252-1260
    CrossrefPubMedSearch in Google Scholar
  • 51 Lebedeva ER, Olesen J, Osipova VV, Volkova LI, Tabeeva GR, Steiner TJ. The Yekaterinburg headache initiative: an interventional project, within the Global Campaign against Headache, to reduce the burden of headache in Russia. J Headache Pain 2013; 14: 101
    CrossrefPubMedSearch in Google Scholar
  • 52 Giorgadze G, Mania M, Kukava M. , et al. Implementation of effective, self-sustaining headache services in the Republic of Georgia: evaluation of their impact on headache-related disability and quality of life of people with headache. Cephalalgia 2018; 38 (04) 639-645
    CrossrefPubMedSearch in Google Scholar
  • 53 Braschinsky M, Haldre S, Kals M. , et al. Structured education can improve primary-care management of headache: the first empirical evidence, from a controlled interventional study. J Headache Pain 2016; 17: 24
    CrossrefPubMedSearch in Google Scholar
  • 54 Braschinsky M, Haldre S, Kals M. , et al. Structured education to improve primary-care management of headache: how long do the benefits last? A follow-up observational study. Eur J Neurol 2018; 25 (03) 497-502
    CrossrefPubMedSearch in Google Scholar
  • 55 Yu S, Steiner TJ. Lifting the burden of headache in China: managing migraine in a SMART way. J Headache Pain 2017; 18 (01) 79
    CrossrefPubMedSearch in Google Scholar
  • 56 Linde M, Steiner TJ, Chisholm D. Cost-effectiveness analysis of interventions for migraine in four low- and middle-income countries. J Headache Pain 2015; 16: 15
    CrossrefPubMedSearch in Google Scholar
  • 57 Mukendi D, Lilo Kalo JR, Mpanya A. , et al. Clinical spectrum, etiology, and outcome of neurological disorders in the rural hospital of Mosango, the Democratic Republic of Congo. Am J Trop Med Hyg 2017; 97 (05) 1454-1460
    CrossrefPubMedSearch in Google Scholar
  • 58 Joint United Nations Programme on HIV/AIDS (UNAIDS). The Gap Report. Geneva: UNAIDS; 2014. http://files.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2014/UNAIDS_Gap_report_en.pdf
    Search in Google Scholar
  • 59 Kirkland KE, Kirkland K, Many Jr WJ, Smitherman TA. Headache among patients with HIV disease: prevalence, characteristics, and associations. Headache 2012; 52 (03) 455-466
    CrossrefPubMedSearch in Google Scholar
  • 60 Evers S, Wibbeke B, Reichelt D, Suhr B, Brilla R, Husstedt I. The impact of HIV infection on primary headache. Unexpected findings from retrospective, cross-sectional, and prospective analyses. Pain 2000; 85 (1-2): 191-200
    CrossrefPubMedSearch in Google Scholar
  • 61 Mirsattari SM, Power C, Nath A. Primary headaches in HIV-infected patients. Headache 1999; 39 (01) 3-10
    CrossrefPubMedSearch in Google Scholar
  • 62 Steiner TJ, Martelletti P. Aids for management of common headache disorders in primary care. J Headache Pain 2007; 8 (Suppl. 01) S2-S2
    PubMedSearch in Google Scholar
  • 63 Mitsikostas DD, Ashina M, Craven A. , et al. European Headache Federation consensus on technical investigation for primary headache disorders. J Headache Pain 2016; 17: 5
    PubMedSearch in Google Scholar
  • 64 Sheikh HU, Cho TA. Clinical aspects of headache in HIV. Headache 2014; 54 (05) 939-945
    CrossrefPubMedSearch in Google Scholar
  • 65 Thakur KT, Mateyo K, Hachaambwa L. , et al. Lumbar puncture refusal in sub-Saharan Africa: a call for further understanding and intervention. Neurology 2015; 84 (19) 1988-1990
    CrossrefPubMedSearch in Google Scholar
  • 66 Rai GS, Rai T, Jain L, Vyas MM, Roshan R. Evaluation of CT and MRI findings among patients presented with chief complaint of headache in Central India. J Clin Diagn Res 2016; 10 (02) TC21-TC25
    PubMedSearch in Google Scholar
  • 67 Forsyth PA, Posner JB. Headaches in patients with brain tumors: a study of 111 patients. Neurology 1993; 43 (09) 1678-1683
    CrossrefPubMedSearch in Google Scholar
  • 68 Ramirez-Lassepas M, Espinosa CE, Cicero JJ, Johnston KL, Cipolle RJ, Barber DL. Predictors of intracranial pathologic findings in patients who seek emergency care because of headache. Arch Neurol 1997; 54 (12) 1506-1509
    CrossrefPubMedSearch in Google Scholar
  • 69 M S, Lamont AC, Alias NA, Win MN. Red flags in patients presenting with headache: clinical indications for neuroimaging. Br J Radiol 2003; 76 (908) 532-535
    CrossrefPubMedSearch in Google Scholar
  • 70 Steiner T. World Headache Alliance. Lifting the burden: The global campaign against headache. Lancet Neurol 2004; 3 (04) 204-205
    CrossrefPubMedSearch in Google Scholar
  • 71 The Lancet. Global Burden of Disease [online]. http://www.thelancet.com/gbd . Accessed December 12, 2017
    PubMed
  • 72 Institute for Health Metrics and Evaluation. Global Burden of Disease (GBD) [online]. http://www.healthdata.org/gbd . Accessed December 12, 2017
    PubMed