Department of Neurology, Douala Laquintinie Hospital, Douala, Cameroon.
Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon.
J Headache Pain. 2024 Aug 16;25(1):133. doi: 10.1186/s10194-024-01831-1.
We have previously shown headache to be highly prevalent in Cameroon. Here we present the attributed burden. We also perform a headache-care needs assessment.
This was a cross-sectional survey among adults (18-65 years) in the general population. Multistage cluster-sampling in four regions (Centre, Littoral, West and Adamawa), home to almost half the country's population, generated a representative sample. We used the standardised methodology of the Global Campaign against Headache, including the HARDSHIP questionnaire, with diagnostic questions based on ICHD-3 and enquiries into symptom burden, impaired participation (lost productivity and disengagement from social activity), quality of life (QoL) using WHOQoL-8, and willingness to pay (WTP) for effective care. We defined headache care "need" in terms of likelihood of benefit, counting all those with probable medication-overuse headache (pMOH) or other headache on ≥ 15 days/month (H15 +), with migraine on ≥ 3 days/month, or with migraine or tension-type headache (TTH) and meeting either of two criteria: a) proportion of time in ictal state (pTIS) > 3.3% and intensity ≥ 2 (moderate-to-severe); or b) ≥ 3 lost days from paid and/or household work in the preceding 3 months.
Among 3,100 participants, mean frequency of any headache was 6.7 days/month, mean duration 13.0 h and mean intensity 2.3 (moderate). Mean pTIS was 9.8%, which (with prevalence factored in) diluted to 6.1-7.4% of all time in the population. Most time was spent with H15 + (5.3% of all time), followed by TTH (1.0%) and migraine (0.8%). For all headache, mean lost days/3 months were 3.4 from paid work, 3.0 from household work and 0.6 from social/leisure activities, diluting to 2.5, 2.2 and 0.6 days/3 months in the population. QoL (no headache: 27.9/40) was adversely impacted by pMOH (25.0) and other H15 + (26.0) but not by migraine (28.0) or TTH (28.0). WTP (maximally XAF 4,462.40 [USD 7.65] per month) was not significantly different between headache types. An estimated 37.0% of adult Cameroonians need headache care.
Headache disorders in Cameroon are not only prevalent but also associated with high attributed burden, with heavily impaired participation. Headache-care needs are very high, but so are the economic costs of not providing care.
我们之前已经表明，头痛在喀麦隆非常普遍。在这里，我们提出了归因于该疾病的负担。我们还进行了头痛护理需求评估。
这是一项在普通人群中进行的成年人（18-65 岁）的横断面调查。在四个地区（中心、滨海、西部和阿达马瓦）进行多阶段聚类抽样，这四个地区几乎占全国人口的一半，产生了一个具有代表性的样本。我们使用了全球头痛防治运动的标准化方法，包括 HARDSHIP 问卷，其中包括基于 ICHD-3 的诊断问题和症状负担、受损的参与度（生产力损失和社交活动脱节）、使用 WHOQoL-8 评估生活质量（QoL），以及对有效护理的支付意愿（WTP）。我们根据可能的药物过度使用性头痛（pMOH）或其他每月头痛天数≥15 天（H15+）的可能性来定义头痛护理“需求”，偏头痛每月头痛天数≥3 天，或偏头痛或紧张型头痛（TTH）且满足以下两个标准之一：a）发作状态（pTIS）比例>3.3%且强度≥2（中度至重度）；或 b）在过去 3 个月中，因头痛丧失了≥3 天的带薪和/或家务工作时间。
在 3100 名参与者中，任何头痛的平均频率为每月 6.7 天，平均持续时间为 13.0 小时，平均强度为 2.3（中度）。平均 pTIS 为 9.8%，（考虑到患病率）稀释到人群中所有时间的 6.1-7.4%。大多数时间用于 H15+（占所有时间的 5.3%），其次是 TTH（1.0%）和偏头痛（0.8%）。对于所有头痛，平均每月丧失带薪工作 3.4 天，丧失家务工作 3.0 天，丧失社交/休闲活动 0.6 天，在人群中分别稀释至 2.5、2.2 和 0.6 天。生活质量（无头痛：40 分中的 27.9 分）受到 pMOH（25.0 分）和其他 H15+（26.0 分）的不利影响，但不受偏头痛（28.0 分）或 TTH（28.0 分）的影响。支付意愿（最高 XAF 4,462.40 [USD 7.65] 每月）在头痛类型之间没有显著差异。估计有 37.0%的喀麦隆成年人需要头痛护理。
喀麦隆的头痛障碍不仅普遍存在，而且还与高归因于疾病的负担有关，严重影响了参与度。头痛护理需求非常高，但不提供护理的经济成本也很高。
