Burden of headache in a HIV-positive population of sub-Saharan Africa

Leone M., Giani L., Phaka M., Uluduz D., Tayyar S., Kamponda M., ...More

CEPHALALGIA, vol.42, pp.918-925, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 42
  • Publication Date: 2022
  • Doi Number: 10.1177/03331024221088994
  • Journal Name: CEPHALALGIA
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.918-925
  • Keywords: Headache, HIV, disease burden, epidemiology, sub-Saharan Africa, Global Campaign against Headache, MULTICENTER, TENOFOVIR, DISEASE
  • Istanbul University Affiliated: Yes


Background About 26 million people are living with HIV in sub-Saharan Africa. The DREAM programme in sub-Saharan Africa provides free healthcare for HIV/AIDS and a range of chronic non-communicable diseases. HIV is a risk factor for neurological non-communicable diseases including stroke and epilepsy, which themselves are associated with headache, and HIV may be a direct risk factor for headache. We investigated the prevalence and burden of headache in a HIV+ population in sub-Saharan Africa. Methods At the DREAM Centre in Blantyre, Malawi, a low-income country with a population of 19 million and 9.2% HIV prevalence, a structured questionnaire was administered by a trained lay interviewer to consecutively attending HIV+ patients aged 6-65 years. All were monitored with regular viral load detection. Results Of 513 eligible patients invited, 498 were included (mean age 34.1 +/- 12.8 years; 72% females; 15 declined). All were on antiretroviral treatment, with viral load undetectable in 83.9%. The 1-year prevalence of headache was 80.3% (females 83.6%, males 71.9%); 3.8% had >= 15 headache days/month, 1.4% had probable medication-overuse headache. Mean overall headache frequency was 4.4 +/- 5.4 days/month. Those reporting headache lost means of 2.3% of paid workdays and 3.3% of household workdays because of headache. Only one third had sought advice for their headache. Conclusions Headache is very prevalent among HIV+ patients in Malawi, imposing additional burden and costs on individuals and the community. Management of headache disorders should be implemented in HIV centres, as it is for other chronic non-communicable diseases.