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Steiner TJ, Husøy A, Thomas H, Stovner LJ. The HARDSHIP databases: a forthcoming free good from the Global Campaign against Headache. J Headache Pain 2023; 24:21. [PMID: 36879195 PMCID: PMC9986863 DOI: 10.1186/s10194-023-01554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
In order to pursue its purpose of reducing the global burden of headache, the Global Campaign against Headache has gathered data on headache-attributed burden from countries worldwide. These data, from the individual participants in adult population-based studies and child and adolescent schools-based studies, are being collated in two databases, which will be powerful resources for research and teaching and rich information sources for health policy.Here we briefly describe the structure and content of these databases, and announce the intention to make them available in due course as a free good.
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Affiliation(s)
- Timothy J Steiner
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway. .,Department of Neurology, University of Copenhagen, Copenhagen, Denmark. .,Division of Brain Sciences, Imperial College London, London, UK.
| | - Andreas Husøy
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, Norwegian Advisory Unit On Headaches, St Olavs Hospital, Trondheim, Norway
| | - Hallie Thomas
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway
| | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, Norwegian Advisory Unit On Headaches, St Olavs Hospital, Trondheim, Norway
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Poudel M, Ojha A, Thapa J, Yadav DK, Sah RB, Chakravartty A, Ghimire A, Sundar Budhathoki S. Morbidities, health problems, health care seeking and utilization behaviour among elderly residing on urban areas of eastern Nepal: A cross-sectional study. PLoS One 2022; 17:e0273101. [PMID: 36070314 PMCID: PMC9451091 DOI: 10.1371/journal.pone.0273101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 08/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background Morbidity increases with age and enhances the burden of health problems that result in new challenges to meet additional demands. In the ageing population, health problems, and health care utilization should be assessed carefully and addressed. This study aimed to identify chronic morbidities, health problems, health care seeking behaviour and health care utilization among the elderly. Methods We conducted a community based, cross-sectional study in urban areas of the Sunsari district using face-to-face interviews. A total of 530 elderly participants were interviewed and selected by a simple proportionate random sampling technique. Results About half, 48.3%, elderly were suffering from pre-existing chronic morbidities, of which, 30.9% had single morbidity, and 17.4% had multi-morbidities. This study unfurled more than 50.0% prevalence of health ailments like circulatory, digestive, eye, musculoskeletal and psychological problems each representing the burden of 68.7%, 68.3%, 66.2%, 65.8% and 55.7% respectively. Our study also found that 58.7% preferred hospitals as their first contact facility. Despite the preferences, 46.0% reported visiting traditional healers for treatment of their ailments. About 68.1% reported having difficulty seeking health care and 51.1% reported visits to a health care facility within the last 6 months period. The participants with pre-existing morbidity, health insurance, and an economic status above the poverty line were more likely to visit health care facilities. Conclusion Elderly people had a higher prevalence of health ailments, but unsatisfactory health care seeking and health care utilization behaviour. These need further investigation and attention by the public health system in order to provide appropriate curative and preventive health care to the elderly. There is an urgent need to promote geriatric health services and make them available at the primary health care level, the first level of contact with a national health system.
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Affiliation(s)
- Mukesh Poudel
- Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal
- * E-mail:
| | - Asmita Ojha
- Health Office, Nuwakot, Ministry of health, Bagmati Province, Hetauda, Nepal
| | - Jeevan Thapa
- Department of Community Health Sciences, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Deepak Kumar Yadav
- School of Public Health & Community Medicine B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Ram Bilakshan Sah
- School of Public Health & Community Medicine B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Avaniendra Chakravartty
- School of Public Health & Community Medicine B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Anup Ghimire
- School of Public Health & Community Medicine B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Shyam Sundar Budhathoki
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Golden Community, Lalitpur, Nepal
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Steiner TJ, Birbeck GL, Jensen RH, Martelletti P, Stovner LJ, Uluduz D, Leonardi M, Olesen J, Katsarava Z. The Global Campaign turns 18: a brief review of its activities and achievements. J Headache Pain 2022; 23:49. [PMID: 35448941 PMCID: PMC9022610 DOI: 10.1186/s10194-022-01420-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/10/2022] [Indexed: 01/11/2023] Open
Abstract
The Global Campaign against Headache, as a collaborative activity with the World Health Organization (WHO), was formally launched in Copenhagen in March 2004. In the month it turns 18, we review its activities and achievements, from initial determination of its strategic objectives, through partnerships and project management, knowledge acquisition and awareness generation, to evidence-based proposals for change justified by cost-effectiveness analysis.
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Affiliation(s)
- Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway. .,Division of Brain Sciences, Imperial College London, London, UK.
| | - Gretchen L Birbeck
- UTH Neurology Research Office, University of Zambia, Lusaka, Zambia.,Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Rigmor H Jensen
- Department of Neurology, Danish Headache Centre, University of Copenhagen, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, Norwegian Advisory Unit On Headaches,, St Olavs Hospital, Trondheim, Norway
| | - Derya Uluduz
- Neurology Department, Istanbul University Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Matilde Leonardi
- Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico C Besta, NeurologyMilan, Italy
| | - Jes Olesen
- Department of Neurology, Danish Headache Centre, University of Copenhagen, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Zaza Katsarava
- Centre of Neurology, Geriatric Medicine and Early Rehabilitation, Evangelical Hospital, Unna, Germany.,Medical Faculty, University of Essen, Essen, Germany
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Steiner TJ, Jensen R, Katsarava Z, Stovner LJ, Uluduz D, Adarmouch L, Al Jumah M, Al Khathaami AM, Ashina M, Braschinsky M, Broner S, Eliasson JH, Gil-Gouveia R, Gómez-Galván JB, Gudmundsson LS, Herekar AA, Kawatu N, Kissani N, Kulkarni GB, Lebedeva ER, Leonardi M, Linde M, Luvsannorov O, Maiga Y, Milanov I, Mitsikostas DD, Musayev T, Olesen J, Osipova V, Paemeleire K, Peres MFP, Quispe G, Rao GN, Risal A, de la Torre ER, Saylor D, Togha M, Yu SY, Zebenigus M, Zewde YZ, Zidverc-Trajković J, Tinelli M. Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description. J Headache Pain 2021; 22:78. [PMID: 34289806 PMCID: PMC8293530 DOI: 10.1186/s10194-021-01265-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/25/2021] [Indexed: 12/14/2022] Open
Abstract
In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the "patient journey") with perplexing obstacles.High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary.The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded.It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.
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Affiliation(s)
- Timothy J Steiner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway.
- Division of Brain Sciences, Imperial College London, London, UK.
| | - Rigmor Jensen
- Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Zaza Katsarava
- Evangelical Hospital Unna, Unna, Germany
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
- EVEX Medical Corporation, Tbilisi, Georgia
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway
- Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St Olavs University Hospital, Trondheim, Norway
| | - Derya Uluduz
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Latifa Adarmouch
- Community Medicine and Public Health Department, Cadi Ayyad University School of Medicine, Marrakech, Morocco
| | - Mohammed Al Jumah
- Department of Neurosciences, King Fahad Medical City, MOH, Riyadh, Saudi Arabia
| | - Ali M Al Khathaami
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Messoud Ashina
- Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Mark Braschinsky
- Headache Clinic, Neurology Clinic, Tartu University Hospital, Tartu, Estonia
| | - Susan Broner
- Weill Cornell Medicine Headache Program, Department of Neurology, Weill Cornell Medical College, New York, NY, USA
| | - Jon H Eliasson
- Department of Neurology, Centralsjukhuset, Kristianstad, Sweden
| | - Raquel Gil-Gouveia
- Headache Centre, Neurology Department, Hospital da Luz, Lisbon, Portugal
| | | | - Larus S Gudmundsson
- Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Akbar A Herekar
- Department of Anesthesiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Nfwama Kawatu
- Department of Paediatrics, University Teaching Hospital, Lusaka, Zambia
| | - Najib Kissani
- Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Université Cadi Ayyad Marrakech, Marrakech, Morocco
- Department of Neurology, University Teaching Hospital Mohammed VI, Marrakech, Morocco
| | - Girish Baburao Kulkarni
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Elena R Lebedeva
- Department of Neurology and Neurosurgery, The Ural State Medical University, Yekaterinburg, Russia
- International Headache Centre "Europe-Asia", Yekaterinburg, Russia
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mattias Linde
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway
- Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St Olavs University Hospital, Trondheim, Norway
- Tjörn Headache Clinic, Rönnäng, Sweden
| | - Otgonbayar Luvsannorov
- Department of Neurology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Youssoufa Maiga
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Ivan Milanov
- Department of Neurology, University Hospital of Neurology and Psychiatry "St Naum", Medical University Sofia, Sofia, Bulgaria
| | - Dimos D Mitsikostas
- 1st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Teymur Musayev
- Chief of Department of Health Organization, Ministry of Health, Baku, Azerbaijan
| | - Jes Olesen
- Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Vera Osipova
- Moscow Research Clinical Centre for Neuropsychiatry, Moscow, Russian Federation
- University Headache Clinic, Moscow, Russian Federation
| | - Koen Paemeleire
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Mario F P Peres
- Institute of Psychiatry, University of São Paulo, Hospital Albert Einstein, São Paulo, Brazil
| | - Guiovanna Quispe
- Department of Neurology, Hospital Luis Negreiros Vega, Callao, Lima, Peru
| | - Girish N Rao
- Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Ajay Risal
- Department of Psychiatry, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | | | - Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
| | - Mansoureh Togha
- Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheng-Yuan Yu
- International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Mehila Zebenigus
- Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yared Zenebe Zewde
- Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Michela Tinelli
- Care Policy and Evaluation Centre, The London School of Economics and Political Science, London, UK
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Manandhar K, Risal A, Koju R, Linde M, Steiner TJ. If headache has any association with hypertension, it is negative. Evidence from a population-based study in Nepal. Cephalalgia 2021; 41:1310-1317. [PMID: 34148406 DOI: 10.1177/03331024211020398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Hypertension and headache disorders are major contributors to public ill health, linked by a long-standing but questionable belief that hypertension is a conspicuous cause of headache. In Nepal, where hypertension is common and often untreated, we assessed the substance of this belief, hypothesising that, should hypertension be a significant cause of headache, a clear positive association between these disorders would exist. METHODS In a cross-sectional, nationwide study, trained health workers conducted face-to-face structured interviews, during unannounced home visits, with a representative sample of the Nepalese adult population (18-65 years). They applied standard diagnostic criteria for headache disorders and measured blood pressure digitally. Hypertension was defined as systolic pressure ≥140 and/or diastolic ≥90 mm Hg. RESULTS Of 2,100 participants (59.0% female, mean age 36.4 ± 12.8 years), 317 (15.1%) had hypertension (41.0% female) and 1,794 (85.4%) had headache (61.6% female; 728 migraine, 863 tension-type headache, 161 headache on ≥15 days/month [mutually exclusive diagnoses]; 42 unclassified headaches).All headache collectively was less prevalent among hypertension cases (78.9%) than non-cases (86.6%; p = 0.001). A negative association between hypertension and all headache was demonstrated in bivariate analysis (odds ratio: 0.6 [95% Confidence interval: 0.4-0.8]; p < 0.001), but did not maintain significance in multivariate regression analysis (adjusted odds ratio: 0.8 [95% Confidence interval: 0.5-1.1]; p = 0.09). The findings were reflected, without significance, in each headache type. CONCLUSIONS If any association exists between hypertension and headache disorders, it is negative. From the public-health perspective, headache disorders and hypertension are unrelated entities: they need distinct policies and programs for prevention, control and management.
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Affiliation(s)
- Kedar Manandhar
- 375889Dhulikhel Hospital, 375889Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,92962Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Ajay Risal
- 375889Dhulikhel Hospital, 375889Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,92962Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Rajendra Koju
- 375889Dhulikhel Hospital, 375889Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,92962Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Mattias Linde
- Department of Neuromedicine and Movement Science, 8018Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian Advisory Unit on Headache, St Olavs University Hospital, Trondheim, Norway
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, 8018Norwegian University of Science and Technology, Trondheim, Norway.,Division of Brain Sciences, 4615Imperial College London, London, UK
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