Headache in the Tropics: Sub-Saharan Africa

  • Redda Tekle Haimanot
Reference work entry


Relatively very limited studies have addressed the epidemiology of headache in tropical countries. The few that have been published are mainly on migraine. Headache in general and migraine in particular, are under-recognized and underdiagnosed in the tropics. Nevertheless, chronic headache appears to be less prevalent in the tropics than in North America and Europe. There are a number of clinical features that make headache in the tropics different from the rest of the world. Headaches due to organic causes, mainly infectious, are common occurrences in the tropics. Contrary to beliefs in the past, migraine is not a rare entity among Africans. Its clinical manifestations are similar to other countries but classical migraine appears to be rare. Food items seem to play a minor role as triggering factors of migraine. Hot climatic conditions tend to exacerbate all types of headache. Due to lack of awareness and limited access to health care facilities, only a small percentage of the headache sufferers in the tropics get modern treatment. Headache symptoms are either tolerated or the sufferer uses herbal medication or goes to the traditional healer for treatment. The disability impact of headache and its effect on quality of life have not been very well evaluated in tropical countries. Considering the paucity of evidence-based data, there is a need for future population-based epidemiological studies of headaches in different tropical countries using standardized protocols in conformity with the classification of the International Headache Society.


Cluster Headache Sickness Absence Traditional Healer Migraine With Aura Tropical Country 
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  1. Adoukonou T, Houinato D, Kankouan J, Makoutode M, Paraiso M, Tehindrazanarivelo A, Vlader F, Preux P-M (2009) Migraine among university students in Cotonou (Benin). J Headache Pain 49:887–893Google Scholar
  2. Amayo EO, Jowi JO, Njeru EK (1996) Migraine headaches in a group of medical students at Kenyatta National Hospital, Nairobi. East Afr Med J 73:594–597PubMedGoogle Scholar
  3. Billinghurst JR (1973) Neurological disorders in Uganda. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 191–206Google Scholar
  4. Collomb H, Dumas M, Girard PL (1973) Neurological disorders in Senegal. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 131–142Google Scholar
  5. Cosnett JE (1973) Neurological disorders in Natal. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 259–272Google Scholar
  6. Dent W, Spiss HK, Helbok R, Matuja WBP, Scheunemann S, Schmutzhard E (2004) Prevalence of migraine in a rural area in South Tanzania: a door-to-door survey. Cephalalgia 24:960–966PubMedCrossRefGoogle Scholar
  7. Getahun MT, Tekle Haimanot R, Martelletti P (2008) Prevalence and burden of primary headache in Akaki textile mill workers, Ethiopia. J Headache Pain 9:119–128CrossRefGoogle Scholar
  8. Haddock DRW (1973) Neurological disorders in Ghana. Uganda. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 143–160Google Scholar
  9. Hagen K, Zwart J-A, Vatten L, Stovner LJ (2000) Bovini G Prevalence of migraine and non-migrainous headache-head-HUNT, a large population-based study. Cephalalgia 20:900–906PubMedCrossRefGoogle Scholar
  10. Harris JR (1973) Neurological disorders in Kenya. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 207–222Google Scholar
  11. Headache Classification Committee of the International Headache Society (1988) Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 8(Suppl 7):1–96Google Scholar
  12. Houinato D, Adoukonou T, Ntsiba F, Adjien C, Avode D-G, Preux P-M (2010) Prevalence of migraine in rural community in south Benin. Cephalalgia 30:62–87PubMedGoogle Scholar
  13. Levy LM (1983) An epidemiological study of headache in an urban population in Zimbabwe. Headache 23:2–9PubMedCrossRefGoogle Scholar
  14. Levy LF, Axton J (1973) Neurosurgery in Rhodesia. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 223–236Google Scholar
  15. Lipton RB (2001) Epidemiology and burden of headache. Adv Stud Med 1:442–445Google Scholar
  16. Lisk Dr (1987) Severe headache in the African: report on 250 cases from Sierra Leone, West Africa. Headache 27:477–483PubMedCrossRefGoogle Scholar
  17. Longe AC, Osuntokun BO (1988) Prevalence of migraine in Udo, a rural community in southern Nigeria. East Afr Med J 65:621–624PubMedGoogle Scholar
  18. Mateen FJ, Dua T, Steiner T, Saxena S (2008) Headache disorder in developing countries: research over the past decade. Cephalalgia 28:1107–1114PubMedCrossRefGoogle Scholar
  19. Matuja WBP (1991) Headache: pattern and features as experienced in a neurology clinic in Tanzania. East Afr Med J 68:359–362Google Scholar
  20. Matuja WB, Mteza IB, Rwiza HT (1995) Headache in a nonclinical population in Dar es Salaam Tanzania. A community-based study. Headache 35:273–276PubMedCrossRefGoogle Scholar
  21. Ogunyemi AO (1984) Prevalence of headache among Nigerian university students. Headache 24:127–130PubMedCrossRefGoogle Scholar
  22. Ojini FI, Okubadejo NU, Danesi MA (2009) Prevalence and clinical characteristics of headache in medical students of the University of Lagos, Nigeria. Cephalalgia 29(4):472–477PubMedCrossRefGoogle Scholar
  23. Okobo ME (1991) Migraine in Nigerian children – a study of 51 patients. Headache 31:673–676CrossRefGoogle Scholar
  24. Oniji GI, Iloeje SO (1997) Childhood migraine in Nigeria: a community-based study. West Afr J Med 16:208–217Google Scholar
  25. Osuntokun BO (1973) Neurological disorders in Nigeria. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 161–190Google Scholar
  26. Osuntokun BO, Osuntokun O (1972) Complicated migraine and haemoglobin AS in Nigerians. Br Med J 1:621–622CrossRefGoogle Scholar
  27. Osuntokun BO, Schoenberg BS, Nottidge VA, Adeuja AOG, Kale O, Adeyefa A et al (1982) Migraine headache in a rural community in Nigeria: results of a pilot study. Neuroepidemiology 1:31–39CrossRefGoogle Scholar
  28. Osuntokun BO, Adeuja AD, Nottidge VA, Bademosi O, Olumide AO, Ige O et al (1992) Prevalence of headache and migrainous headache in Nigerian Africans: a community based study. East Afr Med J 69:196–199PubMedGoogle Scholar
  29. Rachman I (1973) Neurological disorders in Rhodesia. In: Spillane JD (ed) Tropical Neurology. Oxford University Press, London, pp 237–246Google Scholar
  30. Rasmussen BK (1995) Epidemiology of headache. Cephalalgia 15:44–67CrossRefGoogle Scholar
  31. Stewart WF, Lipton RB, Liberman J (1996) Variation in migraine prevalence by race. Neurology 46:52–59Google Scholar
  32. Tekle Haimanot R, Seraw B, Forsgren L, Ekbom K, Ekstedt J (1995) Migraine, chronic tension-type headache, and cluster headache in an Ethiopian rural community. Cephalalgia 15:482–488PubMedCrossRefGoogle Scholar
  33. Wahab KW, Ugheoke AJ (2009) Prevalence and associated disabilities among Nigerian undergraduates. Cephalalgia 36:216–221Google Scholar
  34. Winkler AS, Stelzhammer B, Kerschaumsteiner K, Meindl M, Dent W, Kaaya J, Matuja W, Schmutzhard E (2009) The prevalence of headache with emphasis on tension-headache in rural Tanzania: a community-based study. Cephalalgia 29:1317–1315PubMedCrossRefGoogle Scholar

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© Lifting The Burden 2011

Authors and Affiliations

  • Redda Tekle Haimanot
    • 1
  1. 1.Department of Internal MedicineAddis Ababa UniversityAddis AbabaEthiopia

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