Headache education and management in Cameroon: a healthcare provider study

Abstract

Headache disorders are the most prevalent neurological conditions in the Sub-Saharan Africa and the second cause of disability. In this study, we analyze the knowledge about headache disorders and their management among Cameroonian healthcare providers. We conducted an interventional study with a prospective cohort design. Cameroonian health care providers from the whole country were invited. The evaluation was based on a questionnaire that was done before and after a 4-day educational course. The study included 42 participants, 52.4% female, aged 36.8 years. Participants treated a median of 240 monthly patients. Headache was reported as the most frequent neurological condition in their clinics (34%). Mean number of neurological patients seen per week was 69.3, among them 20 were headache patients. At baseline, only 35.8% correctly mentioned at least one primary headache, increasing to 78.6% after the course (p = 0.002). Secondary headaches were correctly identified by 19.0% at baseline and 40.5% after the course (p = 0.01). Clinical history was considered sufficient for headache diagnosis by 57.1% before and 78.6% after (p = 0.5). Correct red flags were mentioned at baseline by only 14.3% of participants, increasing to 40.5% after the course (p = 0.005). At baseline, the preferred symptomatic was paracetamol (47.6%) and Non-Steroidal Anti-Inflammatory Drugs (9.5%), changing to 23.8 and 66.7% after the course (p = 0.05 and < 0.001). Headache was reported as the most frequent neurological disorders. Knowledge about primary headache disorders and their etiology was scarce, and the clinical concept of red flags was limited. The acute drug of choice was paracetamol.

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Data availability

Datasheets are available for other researchers upon request to the corresponding author.

Abbreviations

SSA:

Sub-Saharan Africa

HCP:

Healthcare provider

ICHD:

The International Classification of Headache Disorders

SD:

Standard deviation

IQR:

Inter quartile range

NSAIDs:

Non-steroidal anti-inflammatory drugs

GDP:

Gross domestic product

CT:

Cranial tomography

EEG:

Electroencephalogram

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Acknowledgements

We want to thank Fundación Recover Hospitales para África Non-Governmental Organization for their support and all the participants and attendees of the course.

Funding

The study did not receive any private or public funding.

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Authors

Contributions

All the authors contributed to the study design. Material preparation, data and analysis were conducted by MHGM and DG-A. The first draft was written by DG-A. All authors commented the subsequent versions, and read and approved the final manuscript.

Corresponding author

Correspondence to David García-Azorín.

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Authors declare not to have any conflict of interest.

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The study was done in accordance to the Declaration of Helsinki principles. Due to the nature of the study, it was not evaluated by ethics review board.

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All the participants were informed about the study, agreed to participate and signed informed consent forms.

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Both participants and authors agreed on publication.

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García-Azorín, D., Molina-Sánchez, M., Gómez-Iglesias, P. et al. Headache education and management in Cameroon: a healthcare provider study. Acta Neurol Belg (2021). https://doi.org/10.1007/s13760-021-01620-6

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Keywords

  • Headache disorders
  • Education
  • Migraine
  • Africa south of the Sahara
  • Therapeutics