Prevalence of Tension-Type Headache among Medical Students in Tabuk University, Saudi Arabia
Authors: Mirghani Hyder Osman , H. Altemani Rayyan Fahad , J. Alharthi Yousef Hussain , R. Alotaibi Mohammed Abdulhafith , A. Alamrani Ahmed Marwan , A. Altawili Abdulaziz , Mohammed AlTurki Abdulrahman , M. Alzahrani Maram Yehia , A. Bawadood Manar Abubaker , Al Qurashi Asawir Mohammed , R. Alshafey Mohammed Aboubaker , H. Albalawi Amal Mohammad , B. Alsubaie Nahaa Eid , Alamari Aisha Abdullah , Saad Alghamdi Saud Abdulrahman 
Published: November 2021

Background: Headaches disorders have a significant burden on the world. Tension Type Headache is the most common type among primary headaches. Since medical students are exposed to a lot of stress, and it is associated with a tension-type headache, the importance of this study comes.  This study aims to measure the prevalence of tension-type headache among medical students at Tabuk University 2020.

Methodology: A cross-sectional study in Tabuk, Saudi Arabia was conducted. The study included medical students at the University of Tabuk in the academic years from 2nd to 6th grades during the calendar year of 2020. An adapted semi-structured self-administered questionnaire was retrieved from other validated questionnaires. The internal validity and reliability of the questionnaire were tested using Cronbach's alpha test and was highly reliable (25 items, α = .715). Both medical and research experts assessed the face and content validity. The data were coded, tabulated, and analyzed using the Statistical Package for the Social Sciences (SPSS, version 27).

Results: The total number of the students was 380 (response rate, 78.6%). 55.22% were females, and 44.78% were males their mean age was 21.18 ± SD 1.78 years. Out of the 297 students, only 122 met the diagnostic criteria. The 1-year prevalence Tension Type Headache (TTH) included the three types: frequent TTH 67.2%, 18.0% infrequent TTH, and only 14.8% suffered from chronic TTH. The most common aggravating factors included studying stressors (82%), 68% of the participants reported daily activity interference, and 48.4% reported that headache aggravate with routine physical activities (e.g., walking or climbing stairs). The headache quality varied between throbbing/pulsating (54.9%), pressing/tightening (68.9%) and sharp/stabbing (10.7%). The median headache intensity was 5.25 at pain level score (IQR =2). Only 28% of the students sought counseling where the main analgesic used was Acetaminophen (74%). Many non-pharmacological therapies were practiced by the students to relieve headache, including sleep (60.7%), rest (63.1%) and caffeine (41.8%).23% of the medical students reported that they sought medical counseling to maintain their performance level. There was a statistically significant difference between the average age of medical students suffering from frequent and infrequent TTH,  t(102) = 2.31, p = .023.

Conclusion: Tension-type headache is a prevalent type of headache among Saudi medical students. Prevalence and aggravating factors in our study were comparable to previously reported literature. Future studies with large sample size may be required among all university students to define burden of the case in Saudi Arabia.