Burden of migraine in a Kuwaiti population: a door- to-door survey

DOI: https://doi.org/10.1186/s10194- 017- 0814- 2

Abstract-Summary Migraine prevalence and disability underreported.

imprints on Kuwaiti population are

We aimed to measure the prevalence of migraine and to assess its burden

in Kuwait.

A total of 15,523 subjects were identified; of whom 3588 (23%) were diagnosed

as episodic migraine and 845 (5.4%) as chronic headache.

Prevalence of episodic migraine was 31.71% in female versus 14.88% in males

(p < 0.01) with a mean age of 34.56 ± 10.17 years.

Tension type headache and sinus-related headaches were diagnosed in 8.9% and

2.1% of migraine subjects respectively.

The majority (94.6%) of migraine subjects used symptomatic drugs for headache

attacks, whereas 39.9% were taking preventive medication.

In the preceding 3 months to the survey, subjects with episodic migraine had lost a mean of 1.97  days from their paid work or school attendance compared to 6.62 days in chronic headache sufferers (p < 0.001).

Subjects with episodic migraine lost a mean of 1.40 days from household work

compared to 5.35 days in subjects with chronic headache (p < 0.001).

Participants with episodic migraine and chronic headache missed a mean of 2.81

and 3.85 days on social occasions, in the preceding 3 months (p < 0.001).

Migraine in Kuwait is highly prevalent and it has a significant impact on activity

of daily living, schooling/ employment and social occasions of patients.

Background Global Burden of Disease Survey (GBD) 2010 [31] estimated that the global preva- lence of migraine is approximately 15% and migraine was ranked as third most common diseases in the world behind dental caries and Tension type head- ache (TTH).

Migraine prevalence in Saudi Arabia, Qatar and Oman, is within the estimated

worldwide prevalence range of 0.7–21.9% [186].

The lifetime migraine prevalence in the three Gulf countries was lower than in

European studies, which report a range of 12–28% [104].

Our study aimed to assess the prevalence of migraine and its burden in Kuwait

through a comprehensive approach utilizing a door-to-door survey.

We further report on the prevalence of episodic migraine stratified by age and gender, characters of migraine in addition to its burden, which was not shown in our previous published paper [187].

1.2

Personal and Societal Burden

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Methods Kuwaiti adults aged 18–65 years who were living in Kuwait for the last 6-month were identified.

One adult member of each household was randomly selected after obtaining an

informed consent.

The survey used several questionnaires such as Lifting The Burden (LTB) [38], Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire [37, 188] which were all translated into Arabic.

Written informed consent was obtained from all the participants and they were

free to decline participation at any time during the interviews.

Collected data was analyzed to assess 1-year prevalence for migraine headache

as percentages with 95% confidence intervals (CIs).

Prevalence of migraine was stratified by gender and age. Categorical variables were described in terms of frequency and proportions (%, with 95% CIs where appropriate), continuous variables in terms of means and stan- dard deviations (SDs).

Results The majority (94.6%) of migraine subjects used symptomatic drugs for their head- ache attacks during the past month, whereas 39.9% were taking preventive medica- tion at the time of the survey.

Subjects with episodic migraine had lost a mean of 1.97 days from their paid work or school attendance, versus 6.62 lost days in patients with chronic headache (p < 0.001).

Subjects with episodic migraine lost a mean of 1.40 days from their household work versus 5.35 lost days in subjects with chronic headache (p  <  0.001) in the preceding 3 months of the survey.

Regarding social and family activities, subjects with episodic migraine and chronic headache missed mean of 2.81 and 3.85 days in the preceding 3 months of the survey (p < 0.001).

Discussion The 1-year prevalence of migraine in our study was 23%, which was higher than previous studies conducted in Arab Gulf countries (Qatar 7.9% [189] and in Oman 10.1% [190]).

More than 38% of migraine subjects were younger than 30  years of age and approximately 68% were in the age group between 18 to 50 years of age similar to previous published studies [98, 100, 191].

Prevalence of migraine in females is high in the 18–30 age group and middle age group (31–40  years) but sharply declined in the postmenopausal age group (51–65 years), which is similar to previous reports [98, 192].

We reported that subjects with episodic migraine lost an average 1.8 days from their paid work in the preceding 3 months to the survey, which was nearly similar to an Italian study of 2.3 lost days [193] and Eurolight project that reported mean lost workdays about 1 day/ month [131].

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1 Public Health

This study is the first and largest population-based survey in Kuwait to estimate the prevalence of migraine headache, and the first to measure migraine- attributed burden.

Conclusions Migraine is prevalent in Kuwait and has a significant socioeconomic burden espe- cially in its chronic form.

Improving the public awareness of migraine through health education of primary care providers and public media may reduce the misdiagnosis and subsequently result in better quality of life and reduce the economic burden.

Acknowledgement A machine generated summary based on the work of Al-Hashel, Jasem Yousef; Ahmed, Samar Farouk; Alroughani, Raed. 2017  in The Journal of Headache and Pain.

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