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Abstract：
BACKGROUND: India is a large and populous country where reliable data on headache disorders are relatively scarce. This study in northern India (Delhi and National Capital Territory Region [NCR], including surrounding districts in the States of Haryana, Uttar Pradesh and Rajasthan) continues the series of population-based studies within the Global Campaign against Headache and follows an earlier study, using the same protocol and questionnaire, in the southern State of Karnataka.
METHODS: This cross-sectional study used the Global Campaign\'s established methodology. Biologically unrelated Indian nationals aged 18-65 years were included through multistage random sampling in both urban and rural areas of NCR. Interviews at unannounced household visits followed the structured Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire in its original English version or in the validated Hindi version. Demographic enquiry was followed by a neutral headache screening question and diagnostic questions based on the International Classification of Headache Disorders edition 3 (ICHD-3), which focused on each respondent\'s most bothersome headache. Questions about headache yesterday (HY) enabled estimation of 1-day prevalence. A diagnostic algorithm first identified participants reporting headache on ≥ 15 days/month (H15+), diagnosing probable medication-overuse headache (pMOH) in those also reporting acute medication use on ≥ 15 days/month, and \"other H15+\" in those not. To all others, the algorithm applied ICHD-3 criteria in the order definite migraine, definite tension-type headache (TTH), probable migraine, probable TTH. Definite and probable diagnoses were combined.
RESULTS: Adjusted for age, gender and habitation, 1-year prevalences were 26.3% for migraine, 34.1% for TTH, 3.0% for pMOH and 4.5% for other H15+. Female preponderance was seen in all headache types except TTH: migraine 35.7% vs. 15.1% (aOR = 3.3; p < 0.001); pMOH 4.3% vs. 0.7% (aOR = 5.1; p < 0.001); other H15 + 5.9% vs. 2.3% (aOR = 2.5; p = 0.08). One-day prevalence of (any) headache was 12.0%, based on reported HY. One-day prevalence predicted from 1-year prevalence and mean recalled headache frequency over 3 months was slightly lower (10.5%).
CONCLUSIONS: The prevalences of migraine and TTH in Delhi and NCR substantially exceed global means. They closely match those in the Karnataka study: migraine 25.2%, TTH 35.1%. We argue that these estimates can reasonably be extrapolated to all India.
METHODS: This cross-sectional study used the Global Campaign\'s established methodology. Biologically unrelated Indian nationals aged 18-65 years were included through multistage random sampling in both urban and rural areas of NCR. Interviews at unannounced household visits followed the structured Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire in its original English version or in the validated Hindi version. Demographic enquiry was followed by a neutral headache screening question and diagnostic questions based on the International Classification of Headache Disorders edition 3 (ICHD-3), which focused on each respondent\'s most bothersome headache. Questions about headache yesterday (HY) enabled estimation of 1-day prevalence. A diagnostic algorithm first identified participants reporting headache on ≥ 15 days/month (H15+), diagnosing probable medication-overuse headache (pMOH) in those also reporting acute medication use on ≥ 15 days/month, and \"other H15+\" in those not. To all others, the algorithm applied ICHD-3 criteria in the order definite migraine, definite tension-type headache (TTH), probable migraine, probable TTH. Definite and probable diagnoses were combined.
RESULTS: Adjusted for age, gender and habitation, 1-year prevalences were 26.3% for migraine, 34.1% for TTH, 3.0% for pMOH and 4.5% for other H15+. Female preponderance was seen in all headache types except TTH: migraine 35.7% vs. 15.1% (aOR = 3.3; p < 0.001); pMOH 4.3% vs. 0.7% (aOR = 5.1; p < 0.001); other H15 + 5.9% vs. 2.3% (aOR = 2.5; p = 0.08). One-day prevalence of (any) headache was 12.0%, based on reported HY. One-day prevalence predicted from 1-year prevalence and mean recalled headache frequency over 3 months was slightly lower (10.5%).
CONCLUSIONS: The prevalences of migraine and TTH in Delhi and NCR substantially exceed global means. They closely match those in the Karnataka study: migraine 25.2%, TTH 35.1%. We argue that these estimates can reasonably be extrapolated to all India.
摘要：
背景：印度是一个人口众多的大国，有关头痛疾病的可靠数据相对匮乏。这项研究在印度北部（德里和国家首都地区[NCR]，包括哈里亚纳邦的周边地区，北方邦和拉贾斯坦邦）在全球头痛运动中继续进行了一系列基于人群的研究，并遵循了较早的研究，使用相同的协议和问卷，在南部的卡纳塔克邦。
方法：这项横断面研究使用了全球运动的既定方法。通过多阶段随机抽样，在NCR的城市和农村地区纳入了18-65岁的生物学无关的印度国民。在未经通知的家庭访问中进行的采访遵循了结构化的头痛归因限制，残疾,原始英文版本或经过验证的印地语版本的社会障碍和受损参与（HARDSHIP）问卷。人口统计调查后，根据国际头痛疾病分类第3版（ICHD-3）提出了中性的头痛筛查问题和诊断问题，它集中在每个受访者最麻烦的头痛上。有关昨天头痛（HY）的问题可以估计1天的患病率。诊断算法首先确定在≥15天/月（H15+）报告头痛的参与者，诊断可能的药物过度使用头痛（pMOH）在那些报告急性药物使用≥15天/月，和“其他H15+”在那些不是。对所有其他人来说，该算法按照确定偏头痛的顺序应用ICHD-3标准，明确紧张型头痛（TTH），可能是偏头痛,可能的TTH。明确的和可能的诊断相结合。
结果：根据年龄调整，性别和居住，偏头痛的1年患病率为26.3％，TTH的34.1%，pMOH为3.0%，其他H15+为4.5%。除TTH外，所有头痛类型均表现为女性优势：偏头痛35.7％vs.15.1%（aOR=3.3；p<0.001）；pMOH4.3%vs.0.7%（aOR=5.1；p<0.001）；其他H15+5.9%vs.2.3%(aOR=2.5；p=0.08)。（任何）头痛的一天患病率为12.0％，根据报告的HY。从1年患病率预测的一天患病率和3个月内平均召回的头痛频率略低（10.5％）。
结论：德里和NCR的偏头痛和TTH的患病率大大超过全球水平。它们与卡纳塔克邦研究中的那些非常吻合：偏头痛25.2%，TTH35.1%。我们认为，这些估计可以合理地推断到整个印度。
方法：这项横断面研究使用了全球运动的既定方法。通过多阶段随机抽样，在NCR的城市和农村地区纳入了18-65岁的生物学无关的印度国民。在未经通知的家庭访问中进行的采访遵循了结构化的头痛归因限制，残疾,原始英文版本或经过验证的印地语版本的社会障碍和受损参与（HARDSHIP）问卷。人口统计调查后，根据国际头痛疾病分类第3版（ICHD-3）提出了中性的头痛筛查问题和诊断问题，它集中在每个受访者最麻烦的头痛上。有关昨天头痛（HY）的问题可以估计1天的患病率。诊断算法首先确定在≥15天/月（H15+）报告头痛的参与者，诊断可能的药物过度使用头痛（pMOH）在那些报告急性药物使用≥15天/月，和“其他H15+”在那些不是。对所有其他人来说，该算法按照确定偏头痛的顺序应用ICHD-3标准，明确紧张型头痛（TTH），可能是偏头痛,可能的TTH。明确的和可能的诊断相结合。
结果：根据年龄调整，性别和居住，偏头痛的1年患病率为26.3％，TTH的34.1%，pMOH为3.0%，其他H15+为4.5%。除TTH外，所有头痛类型均表现为女性优势：偏头痛35.7％vs.15.1%（aOR=3.3；p<0.001）；pMOH4.3%vs.0.7%（aOR=5.1；p<0.001）；其他H15+5.9%vs.2.3%(aOR=2.5；p=0.08)。（任何）头痛的一天患病率为12.0％，根据报告的HY。从1年患病率预测的一天患病率和3个月内平均召回的头痛频率略低（10.5％）。
结论：德里和NCR的偏头痛和TTH的患病率大大超过全球水平。它们与卡纳塔克邦研究中的那些非常吻合：偏头痛25.2%，TTH35.1%。我们认为，这些估计可以合理地推断到整个印度。
