Prevalence and characteristics of headache among medical students in Abidjan: a cross-sectional study

Headache disorders are among the most common neurological complaints worldwide, particularly among medical students who are exposed to high academic stress. This study aimed to assess the prevalence and clinical characteristics of headaches among medical students in Abidjan, Côte d'Ivoire.

A descriptive cross-sectional study was conducted from February to May 2025 among 506 medical students at Félix Houphouët-Boigny University in Abidjan (response rate: 25.0%). Data were collected using a self-administered online questionnaire (Google Forms), which included sections on sociodemographic characteristics, headache frequency and duration, headache types classified according to ICHD-3 criteria, triggering factors, and associated symptoms. Multiple responses were allowed for triggering factors.

Among the 506 participants, 269 (53.2%) were female, with a mean age of 22 years (range: 16-33 years). Headaches were reported by 493 students (97.4%). Tension-type headaches were the most frequent (55.0%), followed by migraine (30.0%) and secondary headaches (15.0%). The distribution of headache phenotypes differed significantly according to sex (χ² = 21.9, df = 2, p < 0.001). Secondary headaches were mainly self-reported as related to dental, sinus, ENT disorders, or malaria. Tension-type headaches were predominantly bilateral (52.6%), whereas migraine was more often unilateral (33.7%). The mean frequency of headache episodes was 3.46 per month and 9.56 over six months, indicating a mostly episodic course. The main triggering factors included lack of sleep (91.5%), prolonged screen exposure (52.4%), and stress (50.6%). Multiple responses were allowed for triggering factors.

Headaches are highly prevalent among medical students in Abidjan, predominantly tension-type. Lifestyle and academic-related stress are major contributors, highlighting the need for preventive strategies and health education in university settings.