The online version of this article (doi:10.1186/1129-2377-15-86) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
ÇW-B initiated and conceived the study and contributed to data interpretation and drafting the manuscript. CW contributed to conception and design, analysis and interpretation of data, and drafted the manuscript. DU, UU, TS, MK, H-EZ and NTAG contributed to the design of the study, performed data acquisition and contributed to the interpretation of the data. GW contributed to the analysis and interpretation of data. AS contributed to conception and design of the study. TJS conceived the study, contributed to the interpretation of the data and revised the manuscript critically. All authors read and approved the final manuscript.
Burden of headache has been assessed in adults in countries worldwide, and is high, but data for children and adolescents are sparse. The objectives of this study were o develop a questionnaire and methodology for the global estimation of burden of headache in children and adolescents, to test these in use and to present preliminary data.
We designed structured questionnaires for mediated-group self-administration in schools by children aged 6-11 years and adolescents aged 12-17 years. In two pilot studies, we offered the questionnaires to pupils in Vienna and Istanbul. We performed face-to-face interviews in a randomly selected subsample of 199 pupils to validate the headache diagnostic questions.
Data were collected from 1,202 pupils (mean 13.9 ± 2.4 years; 621 female, 581 male). The participation rate was 81.1% in Istanbul, 67.2% in Vienna. The questionnaire proved acceptable: ≤5% of participants disagreed partially or totally with its length, comprehensibility or simplicity. The sensitivity, specificity, positive and negative predictive values ranged between 0.71 and 0.76 for migraine and between 0.61 and 0.85 for tension-type headache (TTH). Cronbach’s alpha was 0.83. The 1-year prevalence of headache was 89.3%, of migraine 39.3% and of TTH 37.9%. The prevalence of headache on ≥15 days/month was 4.5%. One fifth (20.7%) of pupils with headache lost ≥1 day of school during the preceding 4 weeks and nearly half (48.8%) reported ≥1 day when they could not do activities they had wanted to. The vast majority of pupils with headache experienced difficulties in coping with headache and in concentrating during headache. Quality of life was poorer in pupils with headache than in those without.
These pilot studies demonstrate the usefulness of the questionnaires and feasibility of the methodology for assessing the global burden of headache in children and adolescents, and predict substantial impact of headache in these age groups.
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- The global burden of headache in children and adolescents – developing a questionnaire and methodology for a global study
Tuna Stefan Aslan
Nancy TA Gerges
Timothy J Steiner
- Springer Milan
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