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

Jul 12, 2022Cephalalgia : an international journal of headache

How common headache problems are among children and teens in Iran based on school surveys

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Abstract

The gender- and age-adjusted 1-year prevalence of any headache among children and adolescents in Iran is 65.4%.

Migraine is reported at a prevalence of 25.2%, while tension-type headache and undifferentiated headache have prevalences of 12.7% and 22.1%, respectively.
Only 4.1% of participants experienced headaches on 15 or more days per month.
Probable medication-overuse headache was identified in 1.1% of participants, increasing five-fold from childhood to adolescence.
Adolescents showed higher prevalence rates for all headache types, except for undifferentiated headache, compared to children.
Undifferentiated headache accounts for over one third of all headache cases in the study population.

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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.

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

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