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Effect of Community-Based Migraine Screening on Migraine Detection among Adults in Nigeria

Abstract

Migraine is a common neurological health condition that may significantly affect the physical, psychological, social, and economic well-being of adults in Nigeria. Recurrent headaches associated with migraine may be accompanied by symptoms such as nausea, vomiting, sensitivity to light or sound, visual disturbances, and reduced ability to perform daily activities. Despite its potential impact on quality of life and productivity, migraine may remain undetected because individuals may attribute recurrent headaches to stress, malaria, fatigue, dehydration, or other causes, while limited access to neurological assessment and inadequate awareness of migraine symptoms may further delay appropriate identification. Community-based migraine screening provides an opportunity to identify adults experiencing recurrent headache patterns suggestive of migraine through primary healthcare centres, community outreach programmes, workplaces, community organizations, and other accessible platforms. Early detection may facilitate appropriate clinical evaluation, headache education, lifestyle modification, treatment, and referral to healthcare professionals where necessary. Against this background, this study investigates the effect of community-based migraine screening on migraine detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Health Promotion Model. The Health Belief Model explains how adults' perceptions of susceptibility to migraine, perceived severity of recurrent headaches, perceived benefits of screening, perceived barriers, and cues to action may influence participation in community-based migraine screening and subsequent healthcare-seeking behaviour. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, socioeconomic, environmental, and healthcare-system factors on headache experiences, health-seeking behaviour, and access to neurological care. The Health Promotion Model emphasizes individual awareness, health-promoting behaviours, perceived benefits, and actions that may encourage individuals to participate in preventive health assessment and seek appropriate care. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based migraine screening may influence migraine detection among adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adults aged 18 years and above residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, primary healthcare centres, workplaces, and eligible participants. Community-based migraine screening will be measured using indicators such as availability of screening programmes, screening coverage, frequency of screening activities, use of validated migraine screening instruments, assessment of headache frequency, headache characteristics, associated symptoms, visual symptoms, sensitivity to light or sound, nausea and vomiting, headache-related disability, availability of trained healthcare personnel, health education, clinical assessment pathways, and referral arrangements. Migraine detection will be assessed using indicators such as newly identified adults with headache patterns suggestive of migraine, positive screening results, adults requiring further clinical assessment, newly recognized recurrent migraine, referrals for medical or neurological evaluation, documented clinical diagnoses where appropriately established, and linkage to appropriate healthcare services. Data will be collected using structured questionnaires, validated migraine screening instruments, headache assessment forms, healthcare records where available, primary healthcare registers, and referral documentation. Descriptive statistics will be used to summarize participants' demographic characteristics, headache patterns, screening coverage, associated symptoms, and migraine detection rates. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of community-based migraine screening on migraine detection. Where appropriate, migraine detection rates before and after implementation of community-based migraine screening activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based migraine screening has a significant positive effect on migraine detection among adults in Nigeria. Adults who participate in community-based migraine screening are expected to have a higher likelihood of previously unrecognized migraine being identified than adults without access to such screening. Systematic screening may facilitate early recognition of recurrent headache patterns and associated migraine symptoms that individuals may otherwise overlook or attribute to other health conditions. Early detection may provide opportunities for appropriate clinical evaluation, headache education, identification of possible triggers, lifestyle modification, appropriate treatment, and referral for specialized neurological assessment when necessary. Conducting screening within communities may reduce geographical, financial, and time-related barriers to healthcare access and may reach adults who rarely seek medical attention for recurrent headaches. Community-based health education may also improve awareness of migraine symptoms and discourage inappropriate self-medication or repeated treatment for presumed alternative causes of headache. Conversely, limited awareness, stigma surrounding recurrent headaches, inadequate screening coverage, shortage of trained healthcare personnel, limited neurological services, financial constraints, and weak referral and follow-up systems may reduce the effectiveness of community-based migraine screening. The study therefore expects accessible and systematically implemented community-based migraine screening to contribute significantly to improved detection and early management of migraine among adults in Nigeria. The study is expected to contribute to the literature on community-based migraine screening, migraine detection, headache disorders, neurological health, community health services, preventive healthcare, health-seeking behaviour, quality of life, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, neurologists, general practitioners, nurses, community health workers, public health practitioners, development partners, and policymakers regarding strategies for improving the identification of migraine and other headache disorders. The study will also provide evidence-based recommendations for expanding community-based migraine screening, increasing public awareness of migraine symptoms, strengthening the capacity of primary healthcare workers to recognize headache disorders, improving referral pathways for neurological assessment, promoting appropriate headache management, reducing inappropriate self-medication, and integrating headache assessment into appropriate community-based primary healthcare programmes across Nigeria.

Keywords: Community-based migraine screening, migraine detection, adults, headache disorders, neurological health, headache assessment, migraine screening, primary healthcare, preventive healthcare, community health services, Nigeria, public health.