The Prevalence and Burden of Primary Headaches in China: A Population-Based Door-to-Door Survey

Authors

  • Shengyuan Yu MD, PhD,

    Corresponding author
    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
      S. Yu, Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China, email: yusy1963@126.com
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  • Ruozhuo Liu MD, PhD,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Gang Zhao MD,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Xiaosu Yang MD,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Xiangyang Qiao MD,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Jiachun Feng MD,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Yannan Fang MD,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Xiutang Cao PhD,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Mianwang He,

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Timothy Steiner MD, PhD

    1. From the Department of Neurology, Chinese PLA General Hospital, Beijing, China (S. Yu, R. Liu, and Mianwang He); Department of Neurology, The Fourth Military Medical University, Xian, Shaanxi Province, China (G. Zhao); Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China (X. Yang); Department of Neurology, Affiliated Huashan Hospital of Fudan University, Shanghai, China (X. Qiao); Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China (J. Feng); Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China (Y. Fang); Department of Health and Economics, Chinese PLA General Hospital, Beijing, China (X. Cao); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (T. Steiner).
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  • Funding: Lifting The Burden, The Global Campaign against Headache.

  • Conflict of Interest: None

S. Yu, Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China, email: yusy1963@126.com

Abstract

Objectives.— In the absence of reliable data on the prevalence and burden of primary headache disorders in the mainland of China, a population-based survey was initiated by Lifting The Burden: the Global Campaign against Headache.

Methods.— Throughout all regions of China, 5041 non-related adult respondents aged 18-65 years were randomly sampled from the general population according to the expanded programme on immunization method established by World Health Organization. They were visited by door-to-door calling and surveyed using the structured questionnaire developed by Lifting The Burden, translated into Chinese and adapted to Chinese culture after a pilot study.

Results.— The responder rate was 94.1%. The estimated 1-year prevalence of primary headache disorders was 23.8% (95% confidence interval 22.6-25.0%), of migraine 9.3% (95% confidence interval 8.5-10.1%), of tension-type headache (TTH) 10.8% (9.9-11.6%), and of chronic daily headache (CDH) 1.0% (0.7-1.2%). Of respondents with migraine, TTH, and CDH, moderate or severe impact and therefore high need for effective medical care were reported by 38.0%, 23.1%, and 47.9%, respectively. The World Health Organization quality of life-8 questionnaire showed that all 3 types of headache reduced life quality. The total estimated annual cost of primary headache disorders, including migraine, TTH, and CDH was CNY 672.7 billion, accounting for 2.24% of gross domestic product (GDP) (direct cost: CNY 108.8 billion, 0.36% of GDP; indirect cost: CNY 563.9 billion, 1.88% of GDP).

Conclusion.— The prevalence of primary headaches is high in China and not dissimilar from the world average. These headaches cause disability, impair work, study and daily activities, decrease life quality, and bring about a heavy and hitherto unrecognized socioeconomic burden.

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