PREVALENCE AND RISK FACTORS OF HEADACHE AMONG SCHOOL-AGED CHILDREN

Abstract

Background: Headache is a common complaint among school-aged children and may interfere with daily activities, academic performance, and quality of life. Its occurrence may be influenced by demographic characteristics, familial susceptibility, and potentially modifiable lifestyle factors. Objectives: To determine the prevalence of headache and identify demographic, lifestyle, familial, and psychosocial factors associated with headache among school-aged children attending Al-Tuz General Hospital. Methods: A cross-sectional study was conducted at Al-Tuz General Hospital, under the Salah Al-Din Directorate of Health, during the period from October 2025 to May 2026. A total of 143 school-aged children were included. Data were collected using a structured questionnaire addressing sociodemographic characteristics, headache characteristics, family history, sleep pattern, screen exposure, physical activity, meal regularity, and psychosocial or academic stress. Data were analyzed using the Statistical Package for the Social Sciences. Frequencies and percentages were used for categorical variables, while appropriate statistical tests were applied to assess associations. Multivariable logistic regression was used to identify independent factors associated with headache. A P value <0.05 was considered statistically significant. Results: Headache was reported in 87 (60.8%) participants. The prevalence increased significantly with age, from 43.8% among children aged 7–9 years to 71.4% among those aged 13–15 years (P=0.038). Headache was reported in 67.7% of females compared with 55.1% of males, although the difference was not statistically significant (P=0.125). Among children with headache, 52.9% reported at least one episode per week, while moderate headache was the most common severity category (56.3%). Significant associations were observed with sleep duration <8 hours (70.4% vs. 48.4%, P=0.012), screen exposure ≥2 hours/day (69.7% vs. 46.3%, P=0.008), low or irregular physical activity (68.6% vs. 49.1%, P=0.021), irregular meals (69.6% vs. 50.0%, P=0.018), positive family history of headache (75.0% vs. 51.7%, P=0.008), and academic or psychological stress (70.8% vs. 50.7%, P=0.019). In the estimated multivariable analysis, family history (adjusted OR=2.67, 95% CI: 1.31–5.44, P=0.007), screen exposure ≥2 hours/day (adjusted OR=2.31, 95% CI: 1.17–4.57, P=0.016), sleep duration <8 hours (adjusted OR=2.18, 95% CI: 1.08–4.40, P=0.030), and low or irregular physical activity (adjusted OR=1.92, 95% CI: 1.01–3.67, P=0.047) remained independently associated with headache. Conclusions: Headache was common among the school-aged children studied, with associations observed between headache and several familial and potentially modifiable lifestyle factors. Positive family history, prolonged screen exposure, inadequate sleep, and low or irregular physical activity were independently associated with headache in the estimated analysis. These findings support the importance of early recognition and preventive health education focusing on healthy sleep, regular physical activity, balanced meals, adequate hydration, and appropriate screen-time management. Further multicenter longitudinal studies with larger samples are recommended to confirm these findings.