Migraine prevalence, clinical characteristics, and health care- seeking practice in a sample of medical students in Egypt

DOI: https://doi.org/10.1186/s41983- 021- 00282- 8

Abstract-Summary To assess the prevalence, characteristics, and degree of disability of migraine in a sample of Egyptian medical students and to study their health care-seeking practice when having migraine A descriptive cross-sectional, questionnaire-based study included 631 undergraduate medical students enrolled in the Faculty of Medicine.

Participants’ sociodemographic data, migraine prevalence, characteristic,

migraine disability, and health care-seeking practice were evaluated.

By using the MIDAS test in the questionnaire, we assessed the impact of migraine

headache on the daily activities of the students.

Prevalence of migraine in medical students was found to be 17.9% causing mod-

erate disability.

1.1

Epidemiology

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Migraine was significantly more prevalent and caused more disability among

female students compared to males (p value 0.001 and 0.001).

Migraine is highly prevalent among medical students with predominant female prevalence and has a negative impact on their academic performance and other activities.

Extended: Migraine is highly prevalent among medical students with predomi-

nant female prevalence.

Introduction Migraine was ranked as the third most prevalent disorder and seventh highest spe- cific cause of disability worldwide in the Global Burden of Disease Survey, 2010 [80].

The prevalence of migraine is generally highest in the most productive years

of life.

In the adult population, females have higher prevalence of migraine compered to

males [81].

The life of medical students usually has multiple triggers for migraine, particu-

larly stress and irregular sleep.

The aim of this work was to assess the prevalence, characteristics, and degree of disability of migraine among medical students in the Faculty of Medicine, and to study the health care-seeking practice of medical students when having migraine.

Methods This study is a descriptive cross-sectional study among undergraduate medical stu- dents enrolled in the Faculty of Medicine, from first to sixth grade during the 2017/2018 academic year.

The questionnaire was designed in English and contained four main sections: section 1, demographic characteristics of the students (age, sex, residence, grade, marital status, and family history); section 2, candidates were asked about the fol- lowing: frequency of headache attacks during the last 3  months, duration of the single attack in hours.

Before study implementation, a pilot test for the questionnaire form was done

among ten potential participants from each grade.

After data collection, each questionnaire was duly studied, and the diagnosis of different types of headache, especially migraine and its subtypes, was made accord- ing to the International Classification of Headache Disorders, third Edition (beta version) as follows: migraine without aura, migraine with aura, chronic migraine, probable migraine [80].

Results According to ICHD 3, the medical students who had migraine in the last 3 months were 113 (17.9%), mostly of episodic type (88.5%).

Migraine headache was described by medical students by being of moderate intensity in nearly three fourths (76.0%) of migrainous students, occurring with frequency of 5–9 episodes every 3 months in more than one third of them (41.9%).

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Students who had migraine described their migraine headache as being unilateral in nearly half (44.2%) of them, throbbing in character and increases with daily activity in three fourths of them (77% and 75.2% respectively).

Married medical students reported higher prevalence of migraine than single stu-

dents (p value 0.030).

Medical students who had family history of headache were having statistically significant higher prevalence of migraine than their classmates with negative family history (p value <0.001).

Discussion Migraine prevalence among medical students in this study was higher compared to migraine prevalence in the Egyptian general population which was 10.5% in Kandil and colleagues, a study conducted in Assiut Governorate, Egypt [82].

Other studies have revealed less positive family history of headache prevalence among medical students with migraine, whereas the prevalence was 20.6% in the study conducted by Ghorbani and colleagues [83].

High proportions of subjects with both migraine with and without aura may be expected in headache-prone populations as medical students reported in several pre- vious clinical studies [84–86].

Our medical students with migraine had experienced mean frequency of attacks

5.96 per month which is higher than previous studies.

Regarding headache characteristics, 94.6% of our medical students with migraine had moderate to severe intensity of their attacks which is higher than that found in other studies [87, 88].

Conclusions Migraine is highly prevalent among medical students with predominant female prevalence.

The Faculty of Medicine should conduct campaigns among students to raise their awareness about the high prevalence of migraine, diagnosis, and its impact on their academic performance.

Stress management programs should be developed so that students can learn the correct methods of stress alleviation which in turn will lessen the impact of migraine on their academic performance and other activities.

Limitations of the Study The main limitation of the study is that it is a single center study.

Although the study included a large number of students, but still it is not repre-

sentative of medical students in Egypt.

Acknowledgement A machine generated summary based on the work of Oraby, Mohammed I.; Soliman, Rasha H.; Mahmoud, Mustafa A.; Elfar, Eman; Abd ElMonem, Noha A. 2021 in The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.

1.1

Epidemiology

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Primary headache disorders in the adult general population of Pakistan—a cross sectional nationwide prevalence survey