Neurology Service, Hospital Luis Negreiros Vega, Callao, Peru.
Department of Nephrology, Peruvian University Cayetano Heredia, Lima, Peru.
J Headache Pain. 2024 Apr 3;25(1):48. doi: 10.1186/s10194-024-01759-6.
The Global Campaign against Headache is conducting a series of population-based studies to fill the large geographical gaps in knowledge of headache prevalence and attributable burden. One major region not until now included is South America. Here we present a study from Peru, a country of 32.4 million inhabitants located at the west coast of South America, notable for its high Andes mountains.
The study was conducted in accordance with the standardized methodology used by the Global Campaign. It was a cross-sectional survey using cluster randomised sampling in five regions to derive a nationally representative sample, visiting households unannounced, and interviewing one randomly selected adult member (aged 18-65 years) of each using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire translated into South American Spanish. The neutral screening question ("Have you had headache in the last year?") was followed by diagnostic questions based on ICHD-3 and demographic enquiry.
The study included 2,149 participants from 2,385 eligible households (participating proportion 90.1%): 1,065 males and 1,084 females, mean age 42.0 ± 13.7 years. The observed 1-year prevalence of all headache was 64.6% [95% CI: 62.5-66.6], with age-, gender- and habitation-adjusted prevalences of 22.8% [21.0-24.6] for migraine (definite + probable), 38.9% [36.8-41.0] for tension-type headache (TTH: also definite + probable), 1.2% [0.8-1.8] for probable medication-overuse headache (pMOH) and 2.7% [2.1-3.5] for other headache on ≥ 15 days/month (H15+). One-day prevalence of headache (reported headache yesterday) was 12.1%. Migraine was almost twice as prevalent among females (28.2%) as males (16.4%; aOR = 2.1; p < 0.001), and strongly associated with living at very high altitude (aOR = 2.5 for > 3,500 versus < 350 m).
The Global Campaign's first population-based study in South America found headache disorders to be common in Peru, with prevalence estimates for both migraine and TTH substantially exceeding global estimates. H15 + was also common, but with fewer than one third of cases diagnosed as pMOH. The association between migraine and altitude was confirmed, and found to be strengthened at very high altitude. This association demands further study.
全球头痛防治运动正在进行一系列基于人群的研究，以填补头痛患病率和可归因负担知识的巨大地域差距。到目前为止，一个主要地区尚未包括在内，那就是南美洲。在这里，我们展示了一项来自秘鲁的研究，秘鲁是一个拥有 3240 万居民的国家，位于南美洲西海岸，以其高耸的安第斯山脉而闻名。
该研究按照全球运动使用的标准化方法进行。这是一项横断面调查，使用了在五个地区进行的聚类随机抽样，以获得具有全国代表性的样本，不事先通知就访问家庭，并使用翻译成南美西班牙语的头痛归因限制、残疾、社会障碍和参与受损 (HARDSHIP) 问卷对每个家庭中随机选择的一名 18-65 岁的成年人进行采访。中性筛选问题（“你在过去一年中有过头痛吗？”）之后是根据 ICHD-3 和人口统计询问进行的诊断问题。
该研究包括来自 2385 个合格家庭的 2149 名参与者（参与率为 90.1%）：1065 名男性和 1084 名女性，平均年龄为 42.0±13.7 岁。观察到的 1 年所有头痛的患病率为 64.6%[95%CI：62.5-66.6]，年龄、性别和居住地调整后的偏头痛患病率为 22.8%[21.0-24.6]（明确+可能），紧张型头痛（TTH：也明确+可能）患病率为 38.9%[36.8-41.0]，可能的药物过度使用性头痛（pMOH）患病率为 1.2%[0.8-1.8]，每月≥15 天的其他头痛（H15+）患病率为 2.7%[2.1-3.5]。昨日头痛的一日患病率为 12.1%。偏头痛在女性中的患病率几乎是男性的两倍（28.2%对 16.4%；优势比[OR] = 2.1；p<0.001），并且与居住在高海拔地区密切相关（OR = 2.5，海拔>3500 米对<350 米）。
全球头痛防治运动在南美洲进行的首次基于人群的研究发现，头痛在秘鲁很常见，偏头痛和 TTH 的患病率估计均大大超过全球估计值。H15+也很常见，但只有不到三分之一的病例被诊断为 pMOH。偏头痛和海拔之间的关联得到了证实，并发现这种关联在高海拔地区更为强烈。这种关联需要进一步研究。
