An Epidemiologic Model for Risk Factors of Migraine and Tension type Headaches among Primary Schools Teachers of Shiraz, 2003.

This study was conducted to estimate the prevalence of migraine and tension-type headaches among Shiraz primary schools teachers and to provide an epidemiologic model for them. A random sample of 538 teachers, constituting a 10% sample of the primary schools teachers’ population, was evaluated on the basis of the diagnostic criteria of the International Headache Society (IHS) as well as clinical diagnosis. The estimated prevalence was 10% (54 subjects) for migraine, 24% (129 subjects) for tension-type headache and 5.2% (28 subjects) for coexisting headaches. In a case-control study, each case of migraine, tension-type and coexisting headache was matched for age, sex and educational region to respectively two, one and three controls selected among headache-free teachers and conditional logistic regression model was used for univariate and multivariate analyses of the relationships between each type of headache and the considered variables. The relationship between the studied headaches and measures of general health questionnaire (GHQ-28) were also determined. Significant associations were found between migraine and positive family history of headache, anxiety and abnormal sleeping pattern. Tension-type headache was significantly associated to positive family history of headache, anxiety, depression, marital status and social dysfunction. Significant associations were found between the coexisting headache and positive family history of headache, anxiety, depression, abnormal sleeping pattern and social dysfunction. No association was found between any type of headaches and blood pressure, body mass index, birth order, study position, cigarette smoking and level of education. Improving general health measures including physical status, social performance, anxiety and depression alleviation in home and school in cases with tension-type headache and correction of sleeping pattern and stress alleviation in subjects with positive family history of migraine headaches are recommended for prevention and treatment of these headaches.