Background The large geographical gaps in our knowledge of the prevalence and burden of headache disorders include most of Eastern Mediterranean Region (EMR). Following a nationwide population-based study in Pakistan, we present here a similar study from Kingdom of Saudi Arabia (KSA). Both were conducted as projects within the Global Campaign against Headache The two purposes of this study were to inform national health policy and contribute to global knowledge of headache disorders. Methods We surveyed Arabic-speaking adults aged 18–65 years in all 13 regions of KSA. While previous Global Campaign studies have engaged participants by calling at randomly selected households, the culture of KSA made this unacceptable. Participants were, instead, contacted by cell-phone (since cell-phone coverage exceeded 100% in KSA), using random-digit dialling. Trained interviewers used a culturally adapted version of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, with diagnostic enquiry based on ICHD-II. We estimated 1-year prevalences of the headache disorders of public-health importance (migraine, tension-type headache [TTH] and probable medication-overuse headache [pMOH]) and examined their associations with demographic variables. Results A total of 2316 participants (mean age of 32.2 ± 10.7 years; 62.3% male; 37.7% female) were included (participation proportion 86.5%). Gender and age distributions imperfectly matched those of the national population, requiring adjustments for these to prevalence estimates. Observed 1-year prevalence of all headache was 77.2%, reducing to 65.8% when adjusted. For headache types, adjusted 1-year prevalences were migraine 25.0%, TTH 34.1%, pMOH 2.0% and other headache on ≥15 days/month 2.3%. Adjusted 1-day prevalence of any headache was 11.5%. Migraine and pMOH were associated with female gender (ORs: 1.7 and 4.7; p < 0.0001). Migraine was negatively associated with age > 45 years (OR: 0.4; p = 0.0143) while pMOH was most prevalent in those aged 46–55 years (OR: 2.7; p = 0.0415). TTH reportedly became more common with increasing level of education. Conclusion Prevalences of migraine and TTH in KSA are considerably higher than global averages (which may be underestimated), and not very different from those in Pakistan. There is more pMOH in KSA than in Pakistan, reflecting, probably, its higher-income status and greater urbanisation (facilitating access to medication).

中文翻译：

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沙特阿拉伯原发性头痛的患病率：一项基于人群的横断面研究

背景 我们对头痛疾病的患病率和负担的认识存在巨大的地理差距，包括东地中海地区 (EMR) 的大部分地区。继巴基斯坦进行了全国范围内的人口研究之后，我们在此介绍沙特阿拉伯王国 (KSA) 的一项类似研究。两项研究都是作为全球抗头痛运动的项目进行的。这项研究的两个目的是为国家卫生政策提供信息并促进全球对头痛疾病的了解。方法 我们对沙特阿拉伯所有 13 个地区 18-65 岁的阿拉伯语成年人进行了调查。虽然之前的全球运动研究通过拜访随机选择的家庭来吸引参与者，但沙特阿拉伯的文化使这种做法无法接受。相反，参与者通过手机（因为沙特阿拉伯的手机覆盖率超过 100%）通过随机数字拨号进行联系。训练有素的访谈员使用了头痛归因限制、残疾、社会障碍和参与障碍 (HARDSHIP) 问卷的文化适应版本，并根据 ICHD-II 进行诊断询问。我们估计了具有公共卫生重要性的头痛疾病（偏头痛、紧张型头痛 [TTH] 和可能的药物过度使用性头痛 [pMOH]）的 1 年患病率，并检查了它们与人口统计学变量的关联。结果 共纳入 2316 名参与者（平均年龄 32.2 ± 10.7 岁；男性 62.3%；女性 37.7%）（参与比例 86.5%）。性别和年龄分布与全国人口的分布不完全匹配，需要根据患病率估计值进行调整。观察到的所有头痛的 1 年患病率为 77.2%，调整后降至 65.8%。对于头痛类型，调整后的 1 年患病率为偏头痛 25.0%、TTH 34.1%、pMOH 2.0%，≥15 天/月的其他头痛为 2.3%。调整后的任何头痛的 1 天患病率为 11.5%。偏头痛和 pMOH 与女性相关（OR：1.7 和 4.7；p < 0.0001）。偏头痛与年龄 > 45 岁呈负相关（OR：0.4；p = 0.0143），而 pMOH 在 46-55 岁的人群中最为常见（OR：2.7；p = 0.0415）。据报道，随着教育水平的提高，TTH 变得更加普遍。结论 沙特阿拉伯的偏头痛和 TTH 患病率远高于全球平均水平（可能被低估），与巴基斯坦的情况没有太大差异。沙特阿拉伯的 pMOH 人数比巴基斯坦多，这可能反映了其较高的收入状况和更大的城市化程度（有利于获得药物）。