{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:51:21Z","timestamp":1787165481923,"version":"build-2736575974"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NTNU Norwegian University of Science and Technology"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Headache Pain"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In our earlier report of headache prevalence among children (6\u201311 years) and adolescents (12\u201317) in Benin, undifferentiated headache (UdH) was defined conventionally as mild headache lasting\u2009&lt;\u20091\u00a0h. In this and similar studies elsewhere in sub-Saharan Africa, we recognised diagnostic uncertainties among the many participants with short-duration headache. Here we make new estimates of prevalence using a modified definition of UdH, and, based on these, estimates of attributed burden. The study was part of the global schools-based programme conducted by the Global Campaign against Headache.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a cross-sectional survey, the child and adolescent versions of the structured HARDSHIP questionnaire, translated into West-African French, were completed by pupils in class in 16 schools representative of Benin\u2019s urban\/rural divide. Headache diagnoses were based on ICHD-3 except for UdH, which we redefined as\n                      <jats:italic>mild or moderate<\/jats:italic>\n                      headache lasting\u2009&lt;\u20091\u00a0h. Enquiry included multiple aspects of attributed burden, with a timeframe of 4 weeks and additional enquiry into headache yesterday (HY).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2,488 eligible pupils, 193 (or their parents) declined, while 2,295 completed the questionnaires (males 1,156 [50.4%], females 1,139 [49.6%]; children 1,081 [47.1%], adolescents 1,214 [52.9%]; mean age 12.1\u2009\u00b1\u20093.1 years [median 12]; participating proportion 92.2%). With the modified definition, observed 1-year prevalence of UdH increased from 8.4% to 21.0%, with corresponding reductions for migraine (from 52.1% to 44.9%) and tension-type headache (TTH) (from 21.8% to 17.2%). Mean symptom burden was expressed in moderate headache on 4.2 days\/4 weeks, with duration 2.8\u00a0h. All headache accounted for 4.0% lost school time according to 4-week recall, 3.3% when assessed from HY (which could not capture lost days immediately preceding weekends or holidays). Almost one in three parents (30.3%) lost time from their own work, those of children more than those of adolescents. Measures of impaired participation clearly distinguished migraine (greater burden) from TTH and UdH<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Headache is prevalent among children and adolescents in Benin. The associated lost health and impaired participation, including lost school time with, potentially, lifelong negative impact, are reliably attributed to headache. Attribution to specific headache types is less certain because of unresolved diagnostic difficulties surrounding short-duration headache.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s10194-026-02448-2","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:06:40Z","timestamp":1784203600000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Headache among children and adolescents in Benin: revised prevalence estimates, and estimates of attributed burden, from a national schools-based study"],"prefix":"10.1186","volume":"27","author":[{"given":"Mendinatou","family":"Agbetou Houessou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Adoukonou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willy","family":"Tchuenga Fokom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly","family":"Dovoedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayyar","family":"\u015ea\u015fmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Bozda\u011f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derya","family":"Uluduz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Kattem","family":"Hus\u00f8y","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"2448_CR1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/s10194-024-01843-x","volume":"25","author":"M Agbetou Houessou","year":"2024","unstructured":"Agbetou Houessou M, Adoukonou T, Tchuenga Fokom W et al (2024) The prevalence of headache disorders in children and adolescents in Benin: a schools-based study. J Headache Pain 25:135","journal-title":"J Headache Pain"},{"key":"2448_CR2","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s10194-018-0847-1","volume":"19","author":"C W\u00f6ber","year":"2018","unstructured":"W\u00f6ber C, W\u00f6ber-Bing\u00f6l C, Uluduz D et al (2018) Undifferentiated headache: broadening the approach to headache in children and adolescents, with supporting evidence from a nationwide school-based cross-sectional survey in Turkey. J Headache Pain 19:18","journal-title":"J Headache Pain"},{"key":"2448_CR3","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/1129-2377-15-86","volume":"15","author":"C W\u00f6ber-Bing\u00f6l","year":"2014","unstructured":"W\u00f6ber-Bing\u00f6l C, W\u00f6ber C, Uluduz D et al (2014) The global burden of headache in children and adolescents \u2013 developing a questionnaire and methodology for a global study. J Headache Pain 15:86","journal-title":"J Headache Pain"},{"key":"2448_CR4","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s10194-022-01420-0","volume":"23","author":"TJ Steiner","year":"2022","unstructured":"Steiner TJ, Birbeck GL, Jensen RH et al (2022) The Global Campaign turns 18: a brief review of its activities and achievements. J Headache Pain 23:49","journal-title":"J Headache Pain"},{"key":"2448_CR5","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s10194-025-02003-5","volume":"26","author":"TJ Steiner","year":"2025","unstructured":"Steiner TJ, Gil-Gouveia R, Hus\u00f8y AK et al (2025) The Global Campaign against Headache, aged 21: a critical self-appraisal, and plans for phase 2. J Headache Pain 26:59","journal-title":"J Headache Pain"},{"key":"2448_CR6","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (2018) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38: 1\u2013211","DOI":"10.1177\/0333102417738202"},{"key":"2448_CR7","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s10194-019-1050-8","volume":"20","author":"J Philipp","year":"2019","unstructured":"Philipp J, Zeiler M, W\u00f6ber C et al (2019) Prevalence and burden of headache in children and adolescents in Austria \u2013 A nationwide study in a representative sample of pupils aged 10\u201318 years. J Headache Pain 20:101","journal-title":"J Headache Pain"},{"key":"2448_CR8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s10194-020-01146-x","volume":"21","author":"D Genc","year":"2020","unstructured":"Genc D, Vai\u010dien\u0117-Magistris N, Zaborskis A et al (2020) The prevalence of headache disorders in children and adolescents in Lithuania: a schools-based study. J Headache Pain 21:73","journal-title":"J Headache Pain"},{"key":"2448_CR9","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1186\/s10194-025-02154-5","volume":"26","author":"NN Tatishvili","year":"2025","unstructured":"Tatishvili NN, Katsarava Z, Shatirishvili T et al (2025) The prevalence of headache disorders among children and adolescents in Georgia: a cross-sectional schools-based study. J Headache Pain 26:282","journal-title":"J Headache Pain"},{"key":"2448_CR10","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1177\/03331024221103814","volume":"42","author":"M Togha","year":"2022","unstructured":"Togha M, Rafiee P, Ghorbani Z et al (2022) The prevalence of headache disorders in children and adolescents in Iran: a schools-based study. Cephalalgia 42:1246\u20131254","journal-title":"Cephalalgia"},{"key":"2448_CR11","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1186\/s10194-025-02129-6","volume":"26","author":"R Ojha","year":"2025","unstructured":"Ojha R, Karn R, Gajurel BP et al (2025) The prevalence of headache disorders in children and adolescents in Nepal: a schools-based cross-sectional study. J Headache Pain 26:218","journal-title":"J Headache Pain"},{"key":"2448_CR12","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s10194-020-01175-6","volume":"21","author":"O Luvsannorov","year":"2020","unstructured":"Luvsannorov O, Anisbayar T, Davaasuren M et al (2020) The prevalence of headache disorders in children and adolescents in Mongolia: a nationwide schools-based study. J Headache Pain 21:107","journal-title":"J Headache Pain"},{"key":"2448_CR13","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s10194-020-01179-2","volume":"21","author":"Y Zenebe Zewde","year":"2020","unstructured":"Zenebe Zewde Y, Zebenigus M, Demissie H et al (2020) The prevalence of headache disorders in children and adolescents in Ethiopia: a schools-based study. J Headache Pain 21:108","journal-title":"J Headache Pain"},{"key":"2448_CR14","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s10194-022-01477-x","volume":"23","author":"N Kawatu","year":"2022","unstructured":"Kawatu N, Wa Somwe S, Ciccone O et al (2022) The prevalence of primary headache disorders in children and adolescents in Zambia: a schools-based study. J Headache Pain 23:118","journal-title":"J Headache Pain"},{"key":"2448_CR15","doi-asserted-by":"crossref","unstructured":"Kawatu N, Wa Somwe S, Ciccone O et al (2026) Headache among children and adolescents in Zambia: revised prevalence estimates, and estimates of attributed burden, from a national schools-based study. J Headache Pain 27:167","DOI":"10.1186\/s10194-026-02438-4"},{"key":"2448_CR16","unstructured":"Institute for Health Metrics and Evaluation Global Burden of Disease (GBD). At: https:\/\/www.healthdata.org\/research-analysis\/gbd"},{"issue":"suppl 1","key":"2448_CR17","first-page":"S45","volume":"8","author":"M Peters","year":"2007","unstructured":"Peters M, Bertolote JM, Houchin C et al (2007) Translation protocol for hybrid documents. J Headache Pain 8(suppl 1):S45\u201347","journal-title":"J Headache Pain"},{"key":"2448_CR18","doi-asserted-by":"publisher","first-page":"e712","DOI":"10.1016\/s2214-109x(15)00069-8","volume":"3","author":"JA Salomon","year":"2015","unstructured":"Salomon JA, Haagsma JA, Davis A et al (2015) Disability weights for the Global Burden of Disease 2013 study. Lancet Glob Health 3:e712\u2013e723. https:\/\/doi.org\/10.1016\/s2214-109x(15)00069-8","journal-title":"Lancet Glob Health"},{"key":"2448_CR19","unstructured":"PopulationPyramid.net At: https:\/\/www.populationpyramid.net\/benin\/2019\/. Accessed 23 November 2025"},{"key":"2448_CR20","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s10194-024-01743-0","volume":"25","author":"Y Zenebe Zewde","year":"2024","unstructured":"Zenebe Zewde Y, Zebenigus M, Demissie H, Tekle\u2013Haimanot R, Uluduz D, \u015ea\u015fmaz T, Bozdag F, Steiner TJ (2024) The burden attributable to primary headache disorders in children and adolescents in Ethiopia: estimates from a national schools-based study. J Headache Pain 25:47","journal-title":"J Headache Pain"},{"key":"2448_CR21","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s10194-017-0818-y","volume":"18","author":"A \u00d6zge","year":"2017","unstructured":"\u00d6zge A, Faedda N, Abu-Arafeh I et al (2017) Experts\u2019 opinion about the primary headache diagnostic criteria of the ICHD-3rd edition beta in children and adolescents. J Headache Pain 18:109","journal-title":"J Headache Pain"},{"key":"2448_CR22","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/1129-2377-15-5","volume":"15","author":"LJ Stovner","year":"2014","unstructured":"Stovner LJ, Al Jumah M, Birbeck GL et al (2014) The methodology of population surveys of headache prevalence, burden and cost: principles and recommendations. A product of the Global Campaign against Headache. J Headache Pain 15:5","journal-title":"J Headache Pain"},{"key":"2448_CR23","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s10194-023-01554-9","volume":"24","author":"TJ Steiner","year":"2023","unstructured":"Steiner TJ, Hus\u00f8y A, Thomas H, Stovner LJ (2023) The HARDSHIP databases: a forthcoming free good from the Global Campaign against Headache. J Headache Pain 24:21","journal-title":"J Headache Pain"},{"key":"2448_CR24","unstructured":"The World Bank School enrollment, secondary (% gross) \u2013 Benin. At: https:\/\/data.worldbank.org\/indicator\/SE.SEC.ENRR?locations=BJ. Accessed 23 November 2025"},{"key":"2448_CR25","first-page":"33","volume":"5","author":"H Daka","year":"2021","unstructured":"Daka H, Chilala MM, Hamatanga OH et al (2021) Averting learner absenteeism in Zambian urban and rural primary schools. A case of Kalingalinga and Simweendengwe primary schools. J Lexicog Terminol 5:33\u201355","journal-title":"J Lexicog Terminol"},{"key":"2448_CR26","first-page":"38","volume":"1","author":"BM Senou","year":"2015","unstructured":"Senou BM (2015) Why do students drop out of school in Benin. Int J Educat Informat Technol 1:38\u201347","journal-title":"Int J Educat Informat Technol"},{"key":"2448_CR27","unstructured":"Action Education At: https:\/\/action-education.org\/en\/menstruation-benin. Accessed 26 June 2026"},{"key":"2448_CR28","unstructured":"Senou BM (2021) Contract type and teacher absenteeism in Benin: The role of teacher\u2019s supplemental income. African Economic Research Consortium, Nairobi. At: https:\/\/publication.aercafricalibrary.org\/server\/api\/core\/bitstreams\/33110ea3-4b37-44ee-95ce-84181e137fdf\/content. Accessed 26 June 2026"}],"container-title":["The Journal of Headache and Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s10194-026-02448-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10194-026-02448-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10194-026-02448-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:50:34Z","timestamp":1786686634000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s10194-026-02448-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2448"],"URL":"https:\/\/doi.org\/10.1186\/s10194-026-02448-2","relation":{},"ISSN":["1129-2377"],"issn-type":[{"value":"1129-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"assertion":[{"value":"13 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Ethics Committee of the University of Parakou (ref: 0265\/CLERB-UP\/P\/SP\/R\/SA). The survey was explained to school managers and teachers of the selected schools, whose agreement to participate was necessary. Pupils\u2019 consents and parental non-objection were required for participation.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"AKH and TJS are Directors and Trustees of\n                      Lifting The Burden\n                      . AKH is a member of the editorial board, and TJS is associate editor, of The Journal of Headache and Pain. Otherwise, no author declares a conflict of interest in relation to the content of this manuscript.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"210"}}