Much of the information relating to the burden of headache comes from developed, high income countries. What is unclear is if this research gives a one-dimensional approach or if the findings are applicable to other, low and middle income parts of the world.
Lifting The Burden undertook an analysis to determine the type and amount of research on primary headache disorders conducted by low and middle income countries (LAMI).
All clinical research, case series, prospective studies and clinical trials on primary headache disorders over the previous decade (1997-2006) were included. Country of origin was stratified into four groups, dependent on gross national income per capita: low, middle, upper middle and high.
In total 227 publications from LAMI were included, mainly from Brazil, Turkey and Iran. Out of a possible 151 LAMI countries, only 32 had conducted headache research. Among the 54 low income countries, only 8 had undertaken any research and primary authors were from institutions in high income countries.
The bulk of studies focused on clinical studies not involving drugs (40.5%) with clinical trials of drug treatment contributing a further 14.5% and epidemiological studies another 37%. Among headache disorders, migraine accounted for almost half of studies.
Overall, the contribution of LAMI countries to headache research is small and focuses mainly on three countries. There is a clear need for further research in these countries to ensure the full global picture of the impact of headache burden is obtained.
FJ Mateen, T Dua, TJ Steiner, S Saxena. Research by low and middle income countries in the primary headache disorders. Poster presented at the International Headache Research Seminar, Chicago, US, March 2008.