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Clinicians' perspectives on complementary and alternative medicine use in headache care across Africa and West Asia: a cross-sectional survey

Hassan A 1 , Dodd-Glover F 2 , Magdy R 1 , Ӧzge A 3 , Uludüz D 4 , Kissani N 5 Show all authors , Allioueche A 6 , Al-Athwari A 7 , Ellouz E 8 , Galieni SBPE 9 , Agbetou M 10 , Okeng'o K 11 , Massi DG 12 , Diarra E 13 , Cedric AP 13 , Okereke CE 14 , Alwachi W 15 , Seidi O 16 , Aden KA 17 , Charway-Felli A 18 , Sakadi F 19 , Jabang JN 20 , Shatima DR 21 , Millogo A 22 , Melanie MA 23 , Djibo FH 24 , Phiri TE 25 , Baco JB 26 , Joël GLR 27 , Mutete F 28 , Alhashel J 29 , Togha M 30 , Mubaidin AF 31 , Amirguliyev S 32 , Moulaye A 33 , Kedah H 34 , Alsayyad A 1 , Khalil DM 35 , Hussein M 36

Affiliations 

  • 1 Department of Neurology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
  • 2 Neurology Unit, Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana
  • 3 Department of Neurology, Headache Clinic, Mersin, Türkiye
  • 4 Neurologist Headache Specialist, Board Member of International Headache Society, Department of Neurology, Faculty of Medicine, Istanbul Atlas University, Istanbul, Türkiye
  • 5 Headache and Epilepsy Clinic, Past Head of Neurology and Neuroscience Department, Mohamed 6th University Hospital, Marrakech, Morocco
  • 6 CHU Constantine, Private Neurologist, Constantine, Algeria
  • 7 Consultant Neurologist and Neuro-interventionist, Aden University, Aden, Yemen
  • 8 Department of Neurology, Gabes Hospital, Sfax University (Université de Sfax), Sfax, Tunisia
  • 9 Department of Neurology, Loandjili General Hospital, Pointe-Noire, Republic of Congo
  • 10 Department of Neurology, University of Parakou, Parakou, Benin
  • 11 Muhimbili National Hospital, Dar es Salaam, Tanzania
  • 12 Faculty of Medicine and Pharmaceutical Sciences, University of Doula, Douala, Cameroon
  • 13 Department of Neurology, CHU Cocody, University Felix Houphouet, Boigny-Abidjan, Côte d'Ivoire
  • 14 University of Nigeria Teaching Hospital, Enugu, Nigeria
  • 15 Neurology Specialist, Head of Neurology Department at Ali Omar Askar Hospital, Tripoli, Libya
  • 16 Faculty of Medicine, University of Khartoum, Khartoum, Sudan
  • 17 Hôpital Militaire de Djibouti, Djibouti City, Djibouti
  • 18 37 Military Hospital, Accra, Ghana
  • 19 Department of Neurology, Nationale Reference Teaching Hospital, N'Djamena, Chad
  • 20 Edward Francis Small Teaching Hospital, University of Gambia, Serekunda, Gambia
  • 21 Department of Paediatrics, National Hospital Abuja, Abuja, Nigeria
  • 22 Centre Hospitalier Universitaire, Souro Sanou, Burkina Faso
  • 23 Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
  • 24 Department of Neurology, Hospital National Amirou Boubacar Diallo of Niamey, Niamey, Niger
  • 25 Queen Elizabeth Central Hospital, Blantyre, Malawi
  • 26 Hospital Central da Beira, Beira, Mozambique
  • 27 Department of Neurology, Université de Bangui, Bangui, République Centrafricaine
  • 28 Livingstone University Teaching Hospital, Livingstone, Zambia
  • 29 Department of Neurology, Kuwait University, Kuwait City, Kuwait
  • 30 Department of Neurology and Headache Fellowship, Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  • 31 Khalidi Medical Center, Amman, Jordan
  • 32 Migraine and Headache Specialist, Baku, Azerbaijan
  • 33 Department of Neurologist, Nouakchott, Mauritania
  • 34 Neurology Consultant, Head of Neurology Department and Program Director of Neurology Saudi Board at Hear Hospital, Makkah, Saudi Arabia
  • 35 Public Health and Community Medicine, Beni-Suef University, Beni Suef, Egypt
  • 36 Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
Front Neurol, 2026;17:1849417.
PMID: 42947770 DOI: 10.3389/fneur.2026.1849417

Abstract

BACKGROUND: Headache disorders impose a substantial burden across Africa and West Asia, where limited access to healthcare may increase reliance on complementary and alternative medicine (CAM). The current study explored clinicians' perspectives on CAM use, safety concerns, and research needs across countries with different income status.

METHODS: A cross-sectional web-based survey of 123 neurologists and headache specialists with at least 5 years of experience in headache management from 37 countries was carried out. They were classified into Low/Lower-Middle Income Countries (LIC/LMIC) and Upper-Middle Income Countries/High Income Countries (UMIC/HIC) groups in accordance with the World Bank income classifications.

RESULTS: Of 123 participants (median age 42 years; 50.4% males), 52.8% were from LICs/LMICs. Clinicians reported that CAMs were frequently used in both groups, and there was no significant difference in overall frequency of CAM use (p = 0.116). Clinicians in both groups perceived migraine as the most common headache type for which patients used CAM. However, significant differences in CAM modalities were observed. Acupuncture (79.3% vs. 47.7%, p

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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