Primary Headache Disorder Among School Students in Kuwait

The prevalence of chronic pain in children and adolescents: a systematic review update and meta-analysis

ABSTRACT

Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem. The objective of this study was to conduct an updated systematic review and meta-analysis on the prevalence of chronic pain (ie, overall, headache, abdominal pain, back pain, musculoskeletal pain, multisite/general pain, and other) in children and adolescents. EMBASE, PubMed, CINAHL, and PsycINFO were searched for publications between January 1, 2009, and June 30, 2023. Studies reporting population-based estimates of chronic nondisease related pain prevalence in children or adolescents (age ≤ 19 years) were included. Two independent reviewers screened articles based on a priori protocol. One hundred nineteen studies with a total of 1,043,878 children (52.0% female, mean age 13.4 years [SD 2.4]) were included. Seventy different countries were represented, with the highest number of data points of prevalence estimates coming from Finland and Germany (n = 19 each, 4.3%). The overall prevalence of chronic pain in children and adolescents was 20.8%, with the highest prevalence for headache and musculoskeletal pain (25.7%). Overall, and for all types of pain except for back pain and musculoskeletal pain, there were significant differences in the prevalence between boys and girls, with girls having a higher prevalence of pain. There was high heterogeneity (I 2 99.9%). Overall risk of bias was low to moderate. In summary, approximately 1 in 5 children and adolescents experience chronic pain and prevalence varies by pain type; for most types, there is higher pain prevalence among girls than among boys. Findings echo and expand upon the systematic review conducted in 2011.

The prevalence and associated factors for primary headache disorders in adolescents in eastern Sudan: a community-based cross-sectional study

Background

Headache disorder is the second-highest cause of disability worldwide; however, data are scarce on headache among adolescents, especially in Africa. There has yet to be published data on headache among adolescents in Sudan, the third-largest country in Africa. This study aimed to assess the prevalence of primary headache disorders and associated factors among adolescents (10-19 years) in eastern Sudan.

Methods

A community-based cross-sectional study was conducted in the city of Gadarif in eastern Sudan. Questionnaires were used to gather the adolescents' sociodemographic characteristics. Headache diagnostic questions were based on the beta version of the International Classification of Headache Disorders-III (ICHD-3). Multivariate analysis was conducted to assess the associated factors for primary headache disorders, and the results were expressed as risk ratios (RRs) and 95.0% confidence interval (CI).

Results

Of the 401 enrolled adolescents, 186 (46.4%) and 215 (53.6%) were male and female, respectively. The median (IQR) age was 14.0 (12.1-16.2) years. Eighty-one (20.2%) of the 401 adolescents reported experiencing primary headache disorders, including migraine with aura in 16 (4.0%), migraine without aura in 33 (8.2%), tension-type in 14 (3.5%), and undifferentiated headache in 18 (4.5%) adolescents. The prevalence of primary headache disorders was significantly higher in females than in males [55/215 (67.9%) vs. 26/186 (32.1%), p = 0.004]. In the multivariate analysis, increased age (RR = 1.09, 95.0 CI = 1.02-1.16) and being female (RR = 1.75, 95.0 CI = 1.14-2.67) were associated with increased RR of primary headache disorders. Parents' education level and occupation, smoking/snuff use, and body mass index were not associated with primary headache disorders.

Conclusion

One-fifth of the adolescents in eastern Sudan reported experiencing primary headache disorders, which was more common in females and with increased age.

Examining the Impact of Puberty on Primary Headache Disorders in Female Schoolchildren: A Cross-Sectional Study

Introduction and aim Headaches are one of the most prevalent childhood disorders. Primary and secondary headaches are the two types of headaches affecting kids and teenagers. The three most typical primary headache forms are tension-type headaches (TTH), migraine, and cluster headaches. This study sought to determine the relationship between puberty and types of headaches. Methods This cross-sectional study was conducted from May 18 to July 31, among female schoolchildren aged between eight and 15 years in the Eastern Province of Saudi Arabia. Respondents were recruited through face-to-face interviews. A self-administered questionnaire was utilized, mainly consisting of demographic data and questions related to diagnosing and managing the impact of puberty in girls on the prevalence of primary headache disorder. Results In total, 481 female schoolchildren were interviewed, mostly between 13 and 15 years old (65.9%). Last year prevalence of headaches was 65.5%, with a significant difference among those who lived in Dhahran (p=0.001) and those with a family history of headaches (p<0.001). The most common type of headache was frequent TTH (16.4%) and chronic TTH (16%). Chronic TTH (p<0.001), frequent TTH (p<0.001), and migraine without aura (p=0.005) were significantly more common among the older age groups.  Conclusion There was a high prevalence of headaches among female schoolchildren, with frequent TTH and chronic TTH being the most common. Furthermore, increasing age was associated with an increasing risk for chronic TTH, frequent TTH, and migraine headaches without aura. More epidemiological studies are necessary to determine the underlying causes of headaches among schoolchildren.

The prevalence of headache disorders in children and adolescents in Iran: a schools-based study

BACKGROUND

While the Global Burden of Disease study reports headache disorders as the third-highest cause of disability worldwide, the headache data in this study largely come from adults. This national study in Iran, the first of its type in the Eastern Mediterranean Region, was part of a global schools-based programme within the Global Campaign against Headache contributing data from children (6-11 years) and adolescents (12-17 years).

METHODS

We followed the generic protocol for the global study. In a cross-sectional survey, self-completed structured questionnaires were administered to pupils within their classes in 121 schools selected from across the country to be representative of its diversities. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of undifferentiated headache.

RESULTS

Of 3,357 potential participants, 3,244 (children 1,308 [40.3%], adolescents 1,936 [59.7%]; males 1,531 [47.2%], females 1,713 [52.8%]) satisfactorily completed the questionnaire. Children and males were therefore somewhat under-represented, with a participating proportion of 96.6%. Gender- and age-adjusted 1-year prevalence of any headache was 65.4%, of migraine 25.2%, of tension-type headache 12.7%, of undifferentiated headache 22.1%, of all headache on ≥15 days/month 4.1%, and of probable medication-overuse headache 1.1%. All headache types except undifferentiated headache were more prevalent among adolescents than children; probable medication-overuse headache increased five-fold between childhood and adolescence.

CONCLUSIONS

Headache disorders are common in children and adolescents in Iran, with undifferentiated headache accounting for over one third of cases. The increasing prevalence of probable medication-overuse headache with age is concerning. These findings are of importance to health and educational policies in Iran.