title: The prevalence and burden of primary headaches in China: a population-based door-to-door survey.
abstract: OBJECTIVE
  In the absence of reliable data on the prevalence and burden of primary headache disorders in the mainland of China, a population-based survey was initiated by Lifting The Burden: the Global Campaign against Headache.
  
  
  METHODS
  Throughout all regions of China, 5041 non-related adult respondents aged 18-65 years were randomly sampled from the general population according to the expanded programme on immunization method established by World Health Organization. They were visited by door-to-door calling and surveyed using the structured questionnaire developed by Lifting The Burden, translated into Chinese and adapted to Chinese culture after a pilot study.
  
  
  RESULTS
  The responder rate was 94.1%.The estimated 1-year prevalence of primary headache disorders was 23.8% (95%confidence interval 22.6-25.0%), of migraine 9.3% (95% confidence interval 8.5-10.1%), of tension-type headache (TTH) 10.8%(9.9-11.6%), and of chronic daily headache (CDH) 1.0% (0.7-1.2%). Of respondents with migraine, TTH, and CDH, moderate or severe impact and therefore high need for effective medical care were reported by 38.0%, 23.1%, and 47.9%, respectively.The World Health Organization quality of life-8 questionnaire showed that all 3 types of headache reduced life quality. The total estimated annual cost of primary headache disorders, including migraine,TTH, and CDH was CNY 672.7 billion, accounting for 2.24% of gross domestic product (GDP) (direct cost: CNY 108.8 billion, 0.36% of GDP; indirect cost: CNY 563.9 billion, 1.88%of GDP).
  
  
  CONCLUSIONS
  The prevalence of primary headaches is high in China and not dissimilar from the world average. These headaches cause disability, impair work, study and daily activities, decrease life quality, and bring about a heavy and hitherto unrecognized socioeconomic burden.
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, China. yusy1963@126.com
authors.forename: Shengyuan
authors.initials: S
authors.lastname: Yu
authors.forename: Ruozhuo
authors.initials: R
authors.lastname: Liu
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
authors.forename: Xiaosu
authors.initials: X
authors.lastname: Yang
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Qiao
authors.forename: Jiachun
authors.initials: J
authors.lastname: Feng
authors.forename: Yannan
authors.initials: Y
authors.lastname: Fang
authors.forename: Xiutang
authors.initials: X
authors.lastname: Cao
authors.forename: Mianwang
authors.initials: M
authors.lastname: He
authors.forename: Timothy
authors.initials: T
authors.lastname: Steiner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D051270:Headache Disorders, Primary / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult