Saha N C, Anwar K S, Mollah A H, Akhter S, Amin M R, Mollah A A
Dr Narayan Chandra Saha, Associate Professor, Child Neurology Division, Institute of Neurological Sciences, Agargaon, Dhaka, Bangladesh.
Mymensingh Med J. 2017 Oct;26(4):831-839.
Magnitude of recurrent headache (RHA) is not well explored among school-children (schoolers) particularly in developing countries like Bangladesh, though recent literature reveals that RHA connotes serious public health implication(s) particularly in schoolers in resource constraint countries. To study age and gender-dependent correlates of RHA among secondary-level schoolers and to determine if these remains its risk-factors. Cross-sectional population based respondent-dependent study employing direct interviews using pre-tested open and closed-ended questionnaire following ICHD-II (2004) diagnostic criteria. Overall, 17% RHA was observed among 1499 schoolers surveyed initially, being more in pubertal/adolescents (13-15 years) than pre-pubertal (11-12 years) ones. Of screened-out 255 RHA positive cases, migraine (MHA) was observed in 55.3% while tension-type-headache (TTH) in 19.6% schoolers. RHA demonstrated a steady-inclining trend with schooler's age. Gender difference was obvious in MHA (p<0.001) but not in TTH (p<0.31). Pubertal schoolers (OR=8.75) and boys (OR=1.8) remained at greater risk for migraine but less risky for TTH. Mass-awareness program is imperative to prevent RHA among schoolers towards progressing it into chronicity, psycho-socially handicapped and economically burdened. Further in-depth studies warrant prudent data to examine its long-term risks/underlying factors involving more diverse population (school-children) from different geographical areas and cultural contexts.
在学童中,复发性头痛(RHA)的严重程度尚未得到充分研究,尤其是在孟加拉国这样的发展中国家,尽管最近的文献表明,RHA具有严重的公共卫生影响,特别是在资源有限国家的学童中。研究中学阶段学童中RHA与年龄和性别的相关性,并确定这些因素是否仍然是其风险因素。采用基于人群的横断面应答者依赖研究,按照国际头痛疾病分类第二版(ICHD-II,2004年)诊断标准,使用预先测试的开放式和封闭式问卷进行直接访谈。总体而言,在最初调查的1499名学童中,观察到17%的RHA,青春期/青少年(13 - 15岁)比青春期前(11 - 12岁)的学童更多。在筛选出的255例RHA阳性病例中,55.3%为偏头痛(MHA),19.6%为紧张型头痛(TTH)。RHA随学童年龄呈稳步上升趋势。MHA存在明显的性别差异(p<0.001),但TTH不存在(p<0.31)。青春期学童(OR = 8.75)和男孩(OR = 1.8)患偏头痛的风险更高,但患TTH的风险较低。开展大众意识项目对于预防学童中的RHA,防止其发展为慢性疾病、造成心理社会障碍和经济负担至关重要。进一步的深入研究需要谨慎的数据,以检查其长期风险/潜在因素,涉及来自不同地理区域和文化背景的更多样化人群(学童)。