The burden of headache disorders in Benin: national estimates from a population-based door-to-door survey

BACKGROUND: Continuing the series of population-based studies conducted within the Global Campaign against Headache, here we report estimates of headache-attributed burden among adults in Benin, West sub-Saharan Africa, adding to those already published of prevalence. METHODS: In a cross-sectional survey using cluster-randomized sampling, we visited households unannounced in three geographical regions of Benin: Borgou, Atlantique and Littoral. We randomly selected and interviewed one adult member (18-65 years) of each household, using the HARDSHIP structured questionnaire. Screening and diagnostic questions based on ICHD-3 were followed by burden enquiry in multiple domains including symptom burden and impaired participation. Enquiry timeframes were 1 year, 3 months, 1 month and 1 day (headache yesterday). Data collection took place from May to July 2020. RESULTS: There were 2,400 participants. Those reporting any headache spent, on average, 8.0% of their total time with headache of moderate-to-severe intensity. Females had more frequent headache than males. Participants with migraine spent twice as much time with headache as those with TTH (5.2% vs. 2.6%). Those with probable medication-overuse headache or other headache on ≥ 15 days/month spent over 50% of their time with headache. Factoring in prevalence and adjusting for age and gender, we estimated that 6.4-6.5% of all time among the adult population of Benin was spent with headache. An estimated 26.7% of the population were assessed as in need of (likely to benefit from) health care for headache. CONCLUSION: The burden of headache in Benin is substantial in terms of lost health. These findings are important to national health and economic policies.