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Published on: June 2, 2014
Primary Headache in Children: Clinical Characteristics and Impact on School Functioning in a Low-Resource Country
Amal Abu Libdeh1, Lara Alsubehat2, Nada Tabbalat2
1The University of Jordan, School of Medicine, Department of Pediatrics, Jordan, Amman.
Insights
Pediatric primary headaches significantly impact school functioning in Jordan. Educational and family factors, not headache type, are key predictors of impairment.
Area of Science:
- Pediatric Neurology
- Public Health
- Child Psychology
Background:
- Primary headaches are common in children, affecting daily life.
- Limited data exists on pediatric primary headaches in Jordan, especially concerning school impact.
Purpose of the Study:
- To evaluate clinical features of pediatric primary headaches in central Jordan.
- To determine the association between these headaches and school functioning.
Main Methods:
- Cross-sectional study of 147 children (5-18 years) with primary headaches.
- Utilized a culturally adapted questionnaire with the Arabic PedsQL 4.0 school-functioning scale.
- Statistical analyses identified factors linked to impaired school functioning.
Main Results:
- Migraine (60.5%) and tension-type headache (23.8%) were most common.
- Over 92% experienced impaired school functioning; poor academic performance and lower paternal education were significant predictors.
- Lifestyle factors like increased screen time and poor hydration were prevalent; headache type/frequency were not significant predictors.
Conclusions:
- Pediatric primary headaches substantially impair school functioning.
- Educational and family factors are more influential than headache characteristics.
- Addressing lifestyle and contextual factors may improve outcomes for children with headaches.
Background:
Primary headaches in children impair daily functioning, yet data from Jordan, particularly regarding their effect on school functioning, have not been systematically evaluated.
Objective:
The objective of this study is to assess the clinical characteristics of pediatric primary headaches in central Jordan and their association with school functioning.
Methods:
A cross-sectional study included children aged 5 to 18 years diagnosed with primary headaches at three public hospitals. Data were collected using a structured, culturally adapted questionnaire incorporating items from the validated Arabic PedsQL 4.0 school-functioning scale. Descriptive, univariable, and multivariable analyses were performed to identify factors associated with impaired school functioning.
Results:
A total of 147 children were included (51% male; 61.2% aged 10-14 years). Migraine was most common (60.5%), followed by tension-type headache (23.8%). Common triggers included stress, noise, and sleep disturbance. Unfavorable lifestyle factors-increased screen time, skipped meals, low hydration, and limited physical activity-were prevalent. More than 92% of participants had impairment in at least one school-functioning domain. Poor academic performance and lower parental education were significantly associated with lower scores. In multivariable analysis, poorer academic performance and lower paternal education remained independently associated with worse school-functioning scores, whereas headache type and frequency were not significant predictors. Most patients used simple analgesics (paracetamol in 93%), whereas migraine-specific rescue medications and preventive therapies were rarely used.
Conclusion:
Primary headaches in children are associated with substantial impairment in school functioning. Educational and family-related factors appear more influential than headache-specific variables. Addressing modifiable lifestyle and contextual factors may improve outcomes.
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