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Despite its high prevalence, migraine is often underreported, underdiagnosed, and inadequately managed\u00a0particularly in the Middle East and North Africa (MENA) region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to\u00a0determine the prevalence of migraine identified by screening, related disability, and psychological comorbidities among university students in the MENA region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multinational cross-sectional study among university students in 11 low and middle-income countries in the MENA region, using an anonymous self-administered questionnaire. The convenience and snowball sampling methods were used. This study utilized a validated questionnaire to collect data on migraine frequency, characteristics, disability, associated depression, anxiety, and triggers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The present study screened a total of 5,954 students for migraine. Of them, 26.1% screened positive for migraine. Iraq had the highest prevalence 38.9%, followed by Algeria 31.5%, and the lowest was in Egypt 19.9% and Morocco 18.4%. Common migraine triggers included\u00a0sleeping disturbances 59.7%, noise 47.4%, and sun exposure 45.6%. Among positive cases, 23.2% had severe disability, 29.9% had moderate anxiety, and 72.5% had severe depression. The main predictors of migraine were females, older age, and non-medical field university students. Adequate hydration, sufficient sleep, regular physical activity, higher fluid intake, and extended study hours were associated with a lower risk of migraine. Daily caffeine consumption was associated with increased migraine risk. A modest negative relationship was found between academic success and migraine disability score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results demonstrated a high proportion of students screened positive for migraine\u00a0with significant associations to depression, anxiety, and disability. These findings highlight the need for targeted interventions to increase awareness about migraine-related comorbidities, screening programs to help in early detection, and lifestyle modification.\u00a0Universities should develop and implement coping strategies to support affected students.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-025-24293-9","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:58:23Z","timestamp":1761562703000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Burden of migraine among university students in the Middle East and North Africa: a cross-sectional study of prevalence, mental health comorbidities, and disability"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3264-031X","authenticated-orcid":false,"given":"Ahmed 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