Modelled migraine burden across Africa, 2009-2023: geographic patterns, demographic drivers, and exploratory projections to 2030

Continent-wide estimates of migraine burden in Africa require cautious interpretation because primary data are uneven and GBD outputs are modelled.

We analysed GBD 2023 point estimates and uncertainty intervals for 54 African countries during 2009-2023. We described incidence, prevalence, and YLDs; assessed age and sex patterns; decomposed changes in absolute burden; performed SDI-based expected-value benchmarking; and conducted exploratory post-2020 trend and ARIMA forecast analyses with diagnostics, rolling validation, and sensitivity models.

In 2023, age-standardised incidence ranged from 802.9 to 1,292.2 per 100,000, prevalence from 9,534.2 to 15,959.0, and YLDs from 338.3 to 570.2. Female-to-male ratios were 1.41-1.73 for incidence, 1.42-1.82 for prevalence, and 1.90-2.31 for YLDs. Population growth explained 88.3%-95.1% of increases in absolute burden. SDI residuals were stable across LOESS spans but were sensitive to edge and influential observations. Primary post-2020 departures were small (-0.35% incidence, +0.32% prevalence, -0.20% YLDs) and changed under a level-scale specification. Conditional 2030 ARIMA projections were 19.87 million incident cases, 219.28 million prevalent cases, and 7.44 million YLDs; alternative point forecasts were similar, but total uncertainty is larger than conditional model intervals.

Modelled migraine burden is substantial and geographically heterogeneous across Africa, with higher female rates and rising counts driven mainly by demographic change. Post-2020 departures and projections are exploratory, non-causal, and model-dependent.