Migraine and Other Headaches Prevalence in the Grand Duchy of Luxembourg: First results.

Colette Andre 1,2, Michel Vaillant 1, Christelle Rott 1, Yolande Wagener 4, JeanMarie Schanck 4, Marie-Lise Lair 1, Peter Sandor 3
Frequency of Migraine

Frequency of other Headaches

46% 36% 36% 42%

(1) (2) (3) (4)

CRP-Sant, CES, Service of Epidemiology and Public Health, Luxembourg Swiss Migraine Trust Foundation, Zurich, Switzerland Department of Neurology, University Hospital, Zurich Direction of Health, Ministry of Health, Luxembourg

37% 38% 31%

38%

16% 7% 7% 8% 9% 9%

18% 12% 2% 2% 4% 2%

days/month

days/month

Background Migraine, a common disabling neurobiological disorder, is still underestimated, under-diagnosed and commonly mismanaged.1 Its prevalence remains unknown for the multicultural and multilinguistic population of the Grand Duchy of Luxembourg. Objective: To estimate the 1-year prevalence and the distribution of migraine and other headaches in the general population as well as the current patterns of health care use.
Age (years) 18-23 24-29 30-35 36-41 42-47 48-53 54-59 60-65 7% 11% 13% 16% 16% 14% 12% 10% English
Men 49% Women 51%

<1

1-3

4-9 Men

10-14 Women

>14

<1

1-3

4-9 Men

10-14 Women

>14

Figure 3: Frequencies of migraine and other headaches attacks

Spoken language Luxembourgish Portuguese French Others German 15% 12% 7% 4% 2%

Others 34% Economic workers 66%

60%

Results 3351 individuals (fig 1) have responded to the questionnaire (54% response rate). The 1-year prevalence for migraine is 29% (39% in females and 20% in males); for other headaches it is 36% (38% in females and 35% in males). Prevalence in migraine is highest between the age of 30 to 47, migraine and other headaches become less prevalent beyond age 53 (fig 2 ). Attack frequency for migraine is higher than for other headache, both are not influenced by working status. (fig 3). From the people who consulted a physician during the last year (58% of migraineurs and 21% of sufferers from other headaches) 65% (migraine) and 55% (other headaches) remembered receiving a medical diagnosis for their headaches. (fig 4)
Diagnosis No 23%
Non

Diagnosis No 32%
Do not

Figure 1: Demographic profile

Methods A self-administered questionnaire (in French, German, Portuguese and English) was sent to a 6500 individuals aged 1865 years selected from the general population, using a random process without repetitions, stratified for age, sex, nationality and living area. The questionnaire included questions about age, sex, spoken language, working status, use of health care services. Migraineurs were identified by using the ID MigraineTM screener2. If the response sample was not representative of the total population, a calibration method CALMAR3 was applied. All participants answering positive to suffering from headache in the last 12 months were invited to answer a second more detailed questionnaire.*
24%
No Headache 35%

consulters 42% Consulters 58%

Non consulters 79% Consulters 21%

Do not remember 13%

remember 12% Diagnosis Yes 65%

Diagnosis Yes 55%

Figure 4 : Physician consulting and frequency of diagnosis for migraine

: Physician consulting and frequency of diagnosis for other headaches

46% 37%

Conclusions In Luxembourg the 1-year prevalence of migraine is (29%) using the ID Migraine screener. Migraine is more prevalent in women as opposed to "other headaches", both decline with age beyond 53. Attack frequency is higher for migraine than for "other headaches", attack frequency is not influenced by working status. Differences in migraine prevalence in relation to other countries (17%20%)4,5 could be partially resulting from the use of different diagnostic criteria. The ID MigraineTMscreener, a validated diagnostic tool, was used for detecting migraine has a sensitivity of 75% and specificity 81% compared to the diagnostic criteria of the International Headache Society (se=85% and sp=96%), Further analyses need to be carried out.
References 1 The World Health Report: 2001: Mental Health: New Understanding, New Hope : 2001 2 Lipton RB, Dodick D, Sadovsky R, Kolodner K, Endicott J, Hettiarachchi J, Harrison W; ID Migraine validation study.A self-administered screener for migraine in primary care: The ID Migraine validation study.Neurology. 2003 Aug 12;61(3):375-82. 3 Olivier Sautory; Le macro CALMAR, Redressement dun chantillon par calages sur marges. Institut National de la Statistique et des Etudes Economiques 1993 4 Henry P, Michel P, Brochet B, Dartigues JF, Tison S, Salamon R.A nationwide survey of migraine in France: prevalence and clinical features in adults. GRIM. Cephalalgia. 1992 Aug;12(4):229-37 5 Launer LJ, Terwindt GM, Ferrari MD. The prevalence and characteristics of migraine in a population-based cohort: the GEM study. Neurology 1999 Aug 11;53(3):537-42. * BURMIG questionnaire, Poster IHC Kyoto, October 2005

Other Headaches 36%

Migraine 29%

35% 39% 20%

Men
Mi grai ne Oth. Headaches

Women
No Headache

30%

32%

27%

30%

30%

39%

48%

63%

39%

39%

39%

37%

37%

34%

31% 26% 22%

31%

29%

33%

33%

33%

27%

12%

Age (years)

18-23 23-29 30-35 36-41 42-47 48-53 54-59 60-65

Migraine Other Headaches No Headache

Figure 2: Prevalence of migraine and headache

Swiss Migraine Trust Foundation