Saylor Deanna, Steiner Timothy J
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
Semin Neurol. 2018 Apr;38(2):182-190. doi: 10.1055/s-0038-1646946. Epub 2018 May 23.
At the turn of the century, most of the world's population lived in regions where the prevalence of headache was unknown and its impact poorly understood. Lifting The Burden (LTB), a nonprofit organization in official relations with the World Health Organization, established the Global Campaign against Headache, with the ultimate purpose of reducing the burden of headache worldwide. First, the scope and scale of this burden had to be known. LTB embarked upon a program of population-based studies in countries in all world regions in order to achieve its aim. Its studies have demonstrated a high prevalence of headache disorders, including migraine, tension-type headache, and medication-overuse headache, and their associations with impaired quality of life, substantial lost productivity, and high economic costs in every country surveyed. Informed by these, the Global Burden of Disease study ranks headache disorders as the second leading cause of years lived with disability worldwide; migraine alone is third among people aged 15 to 49 years. With interventions urgently needed to reduce these burdens throughout the world, we review the epidemiological studies conducted by LTB, examine proposed interventions to improve provision of headache care including a three-tier system of structured headache services, and consider the challenges still remaining in providing effective, efficient, and equitable headache care especially in low-income countries.
在世纪之交，世界上大多数人口居住在头痛患病率未知且其影响也未得到充分了解的地区。与世界卫生组织保持官方关系的非营利组织“减轻负担”（Lifting The Burden，简称LTB）发起了全球抗头痛运动，其最终目的是减轻全球范围内的头痛负担。首先，必须了解这种负担的范围和规模。LTB在世界所有地区的国家开展了一项基于人群的研究计划，以实现其目标。其研究表明，头痛疾病，包括偏头痛、紧张型头痛和药物滥用性头痛，在每个接受调查的国家都有很高的患病率，并且它们与生活质量受损、生产力大幅下降以及高昂的经济成本相关。基于这些情况，全球疾病负担研究将头痛疾病列为全球致残生存年数的第二大主要原因；仅偏头痛在15至49岁人群中就位列第三。鉴于迫切需要在全球范围内采取干预措施来减轻这些负担，我们回顾了LTB进行的流行病学研究，审视了为改善头痛护理提供所提议的干预措施，包括结构化头痛服务的三级系统，并考虑了在提供有效、高效且公平的头痛护理方面仍然存在的挑战，尤其是在低收入国家。
