Review Article

The Epidemiology of Migraine Headache in Arab Countries: A Systematic Review

Table 1

Characteristics of included articles.

Author [ref]CountryStudy durationStudy populationStudy typeDiagnostic criteriaSample sizeStudy quality score (8)Migraine Prevalence (%)Other results

Abduljabbar et al. [24]Saudi ArabiaOct 1994–Mar 1995 (6 months)>15 years oldA community survey (door-to-door)IHS criteria5,891,473 suffered from headache32.6Most of headache sufferers were women. The age-specific rate was increasing with a peak in the sixth decade.

Ai‐Rajeh et al. [8]Saudi ArabiaDec 1983–Nov 1988All populationEvaluation of patients with headache as the key reason for their visits in the hospital.The definition of Blau, 1984.222122Migraine showed a higher prevalence among Saudi females only in the fourth decade (female-to-male ratio of 4 : 1). 10% of the cases presented positive family history for headache. Major headache precipitating factors were stress, prolonged exposure to excessive sunlight or heat, and hunger.

Jumah et al. [25]Saudi Arabia1 yearSchoolchildren (6–18 years)A cross-sectional, questionnaire-based studyIHS criteria1,40037.1For migraine, in both boys and girls, prevalence rate sharply increased from around 2% to around 9% at age 10 to 11.

Jumah et al. [26]Saudi Arabia1 year18–65 yearsA country-wide population-based cross-sectional survey2,421432This study shows a high prevalence of migraines among men.

Almalki et al. [27]Saudi ArabiaGeneral populationA cross-sectional survey studyIHS criteria354278.5Migraine prevalence was found to be higher in urban areas and among females. An association was found between migraines and high rates of unemployment. The most common symptom associated with migraine was nausea.

Al-Tulaihi et al. [10]Saudi Arabia2002-2003High school students (16–21 years)A cross-sectional, questionnaire-based studyIHS criteria175037.7Migraine shows higher prevalence in females than males.

Ibrahim et al. [28]Saudi Arabia2014-2015Medical students (2nd–6th year)A cross-sectional studyID Migraine test™, Numeric Pain Rating Scale (NPRS).566626.3The major migraine predictors were found to be functional gastrointestinal disorders (FGIDs), family history of migraine, female gender, and enrolment in the second academic year. The most common triggers were exam stress and sleep disturbances.

Garah et al. [29]Saudi Arabia2013-2014Female university studentsA cross-sectional studyIHS criteria395561.77The most common triggers were physical stimulation (like light, loudness, change in weather, and certain smells). Among students, the most important migraine relieving factors were rest and sleep (63.5%), medication (33.2%), followed by darkening room (30.3%), massage (20.1%), and coffee drinking (18%). A significant association was found between migraine headache and family history of migraine and studying in theoretical colleges.

Jamal et al. [30]KuwaitMar 2003–Jun 200315–80 yearsA cross-sectional studyIHS criteria290111.7There was no evidence to prove a positive correlation between high blood pressure and headache.

Al-Hashel et al. [31]Kuwait2012-2013Medical studentsA cross-sectional, questionnaire-based studyIdentification of migraine (ID Migraine™)621227.9The most common triggering factors in students were stress (24.9%), irregular sleep (20.8%), and substantial reading tasks (18.5%). Migraine prevalence showed an increase in the final two years of education.

Al-Hashel et al. [32]KuwaitJan 2016–Apr 2016 (4 months)18–65 yearsA population-based cross-sectional survey (door-to-door)ICD-II criteria15,523423.11Highly prevalent condition having a significant impact on daily living activity, employment/schooling, and social occasions of patients.

Badry et al. [33]EgyptJul 2009–Jan 2012 (31 months)>8 year oldA door-to-door screening and an examination surveyWHO33,28352.8The highest prevalence was recorded in the elderly population (60+ years, 8.0%) and among the age group 18–39 years (5.4%).

El-Sherbiny et al. [34]EgyptJan 2014–Oct 201415–83 yearsA community-based, cross-sectional observational descriptive survey.ICD-IIIb2600617.3Migraine shows higher prevalence in females than males.

Kandil et al. [35]EgyptAll populationA cross-sectional population-based study (door-to-door)HIS & ICD-II4,700310.55Chronic or daily migraine was more common in females (35.3% versus 20.7% for males). Migraine attack duration was found to get shorter with increasing age, but the chronic (daily) migraine showed an increasing prevalence with age. The most common comorbidities with migraines were hypertension, anxiety, irritable bowel syndrome, and depression.

Bener [36]QatarOct 2004–Dec 2004>15 years oldA cross-sectional population-based study.IHS criteria91347.9Most common warning symptoms before headaches were weakness (30.4%) and abnormal vision (53.0%). Factors that were found to make headache worse included stress (71.8%) and weather (49.5%).

Bessisso et al. [37]QatarMar 2001–Apr 2003Schoolchildren (6–17 years)A cross-sectional surveyIHS criteria851511.9The most common triggers were found to be lack of sleep (17.6%) and fatigue (35.8%).

Deleu et al. [38]Oman1999-2000 (2 year)>10 years oldA community-based studyIHS criteria1,158310.1In this study, migraine prevalence did not show significant gender difference (4.5% in male and 5.6% in female).

Deleu et al. [39]Oman2001Medical studentsA college-based, cross-sectional surveyIHS criteria403412.2A significant gender distribution difference of migraine prevalence was 6.6% of men and 15.5% of women.

Alzoubi et al. [40]JordanJan 2007–Nov 200818–85 yearA community-based, cross-sectional study4,83637.7Headache and overuse of analgesics was prevalent.

ALBashtawy et al. [41]Jordan3 weeksSchool students (16–18 years)A school-based, cross-sectional studyIHS criteria75448.8This study indicated that migraine prevalence was initially high and increased with age.

Romdhane et al. [42]TunisiaJul 1985A full-scale survey evaluated by a second survey.WHO & ICD1,67358.6%Migraine prevalence ratios in Nigeria, Ecuador, and Kelibia were equivalent.

Abdo et al. [43]YemenJul 2010–Sep 201118–85 yearsA cross-sectional observational studyIHS criteria12,640314.48The study demonstrated a high prevalence of headache in Kuwait with 76.5% of the subjects experiencing headache attacks at least once per year

Bener et al. [9]United Arab EmiratesOct 1995–Jun 1996Schoolchildren (6–14 years)A cross-sectional population-based studyIHS criteria1,159513.7Headache prevalence increases with age. Highest rate was found among 13-year-olds (17.5%).

Sabra et al. [44]Saudi Arabia2015General populationA cross-sectional population-based studyIHS criteria1002410.8%Out of the atypical complaints, 86% of the patients had a history of concomitant typical presentation.