Disability burden, treatment gaps and correlates of self-reported physician-diagnosed migraine: a multinational...

Migraine causes substantial disability in North African Arab countries, yet disease severity, treatment adequacy and healthcare utilisation remain poorly characterised. This study aimed to characterise the severity of migraine-related disability, assess medication utilisation and identify factors associated with receiving a physician diagnosis among a surveyed adult cohort.

A multinational cross-sectional analytical study was conducted using an online survey distributed to adults via convenience sampling in Egypt, Sudan, Algeria and Libya in February 2026. The primary outcome was the frequency of self-reported physician-diagnosed migraine, and migraines were considered controlled if no attacks occurred in the past 3 months. Disability was quantified using the Arabic Migraine Disability Assessment (MIDAS) scale, and factors associated with the diagnosis were analysed using multivariable logistic regression.

Of 1763 participants included, 20% (n=352) reported a physician diagnosis of migraine. Among the diagnosed cohort, only 19.6% (n=69) were controlled, while 26.7% experienced severe disability (MIDAS grade IV). Among participants with uncontrolled migraine (n=283), 39.9% reported using no medication for symptom relief. In the multivariable analysis, family history of migraine was strongly associated with a higher likelihood of reporting a diagnosis (adjusted OR (AOR) 5.13, 95% CI 3.99 to 6.62), while male sex was associated with lower odds (AOR 0.56, 95% CI 0.40 to 0.77).

A substantial proportion of the surveyed cohort reports physician-diagnosed migraine characterised by severe disability and significant treatment gaps. Furthermore, diagnosis reporting is strongly linked to female sex and family history, likely reflecting differences in health-seeking behaviour and awareness.