article · The Journal of Headache and Pain
Data regarding headache prevalence in sub-Saharan Africa has historically been scarce, with previous reliable surveys limited to Zambia and Ethiopia. To fill this gap for Central Africa, a nationwide survey investigated headache disorders across four diverse regions of Cameroon using cluster-randomised household sampling. Trained interviewers administered the standardised HARDSHIP questionnaire to randomly selected adults aged 18 to 65. The findings reveal that headache is nearly universal in Cameroon, with an adjusted one-year prevalence of 76.4 percent. Tension-type headache affected 44.4 percent of participants, while migraine affected 17.9 percent, both exceeding global average estimates. Additionally, probable medication-overuse headache affected 6.5 percent of adults and was linked to rural residence, whereas migraine and tension-type headaches were associated with urban dwelling. The findings highlight an urgent need to establish targeted headache care and prevention strategies across the country.
Headache disorders place a significant strain on population health, yet they remain poorly documented across much of Africa. By establishing rigorous nationwide prevalence figures for Cameroon, this work provides public health authorities with the evidence required to design targeted clinical services, train healthcare providers, and formulate management strategies that address both primary headaches and complications such as medication overuse.
The abstract does not indicate an application pathway, as it focuses on epidemiological prevalence data rather than a commercial product or service.
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BACKGROUND: Knowledge of headache prevalence, and the burdens attributable to headache disorders, remains incomplete in sub-Saharan Africa (SSA): reliable studies have been conducted only in Zambia (southern SSA) and Ethiopia (eastern SSA). As part of the Global Campaign against Headache, we investigated the prevalence of headache in Cameroon, in Central SSA. METHODS: We used the same methodology as the studies in Zambia and Ethiopia, employing cluster-randomized sampling in four regions of Cameroon, selected to reflect the country's geographic, ethnic and cultural diversities. We visited, unannounced, randomly selected households in each region, and randomly selected one adult member (aged 18-65 years) of each. Trained interviewers administered the Headache-Attributed Restriction, Disability and Impaired Participation (HARDSHIP) structured questionnaire, developed by an international expert consensus group and translated into Central African French. Demographic enquiry was followed by diagnostic questions based on ICHD-3 criteria. RESULTS: Headache was a near-universal experience in Cameroon (lifetime prevalence: 94.8%). Observed 1-year prevalence of headache was 77.1%. Age- and gender-adjusted estimates were 76.4% (95% confidence interval: 74.9-77.9) for any headache, 17.9% (16.6-19.3) for migraine (definite + probable), 44.4% (42.6-46.2) for tension-type headache (TTH; also definite + probable), 6.5% (5.7-7.4) for probable medication-overuse headache (pMOH) and 6.6% (5.8-7.6) for other headache on ≥ 15 days/month (H15 +). One-day prevalence ("headache yesterday") was 15.3%. Gender differentials were as expected (more migraine and pMOH among females, and rather more TTH among males). pMOH increased in prevalence until age 55 years, then declined somewhat. Migraine and TTH were both associated with urban dwelling, pMOH, in contrast, with rural dwelling. CONCLUSIONS: Headache disorders are prevalent in Cameroon. As in Zambia and Ethiopia, estimates for both migraine and TTH exceed global mean estimates. Attributable burden is yet to be reported, but these findings must lead to further research, and measures to develop and implement headache services in Cameroon, with appropriate management and preventative strategies.
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DOI: 10.1186/s10194-024-01748-9
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