Guidance

Afghanistan: migrant health guide

Advice and guidance on the health needs of migrant patients from Afghanistan for healthcare practitioners.

Main messages

If the patient is new to the UK:

  • explain to them how the NHS works
  • discuss how this compares to the healthcare system they’ve been used to

Ensure that all patients are up-to-date with the UK immunisation schedule.

Screen all new entrants, including children, for tuberculosis (TB).

Determine any risk factors for hepatitis B infection that may indicate the need for screening, because Afghanistan has a low prevalence.

Consider screening for hepatitis C, because Afghanistan has a considerably higher prevalence of hepatitis C than the UK.

Be alert for signs and symptoms of polio, and ensure vaccination as required, because polio is endemic in Afghanistan.

Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin, and see National Travel Health Network and Centre (NaTHNaC), or the Health Protection Scotland websites (TRAVAX and fitfortravel), for travel advice.

Be advised that there is a risk of malaria in some areas of Afghanistan.

Be advised that there is a risk of typhoid infection in Afghanistan.

Find out more about children’s health.

Infectious diseases

Immunisation

Ensure that all patients, especially children, are up-to-date with the UK immunisation schedule. See the immunisation collection with current schedules.

Tuberculosis (TB)

The incidence of TB in Afghanistan is high (40 to 499 cases per 100,000), so:

  • screen all new entrants (including children) for TB according to NICE guidelines
  • refer to TB services promptly if screening is positive
  • maintain long term vigilance for symptoms of TB even if initial screening is negative
  • be aware that TB is a notifiable disease

Sexually transmitted infections and HIV

Take a sexual history, and:

  • screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
  • test all sexually active patients under the age of 25 for chlamydia

Afghanistan has a low rate of HIV (≤1%), so:

  • offer and recommend an HIV test if the patient:
    • falls into a high risk group
    • is newly registering in a high prevalence area
  • be advised that national guidelines do not recommend routine consideration of HIV testing of infants and children who have recently arrived in the UK

Hepatitis B

Afghanistan has a low prevalence of hepatitis B, so:

  • offer screening for hepatitis B to all pregnant women during each pregnancy
  • immunise appropriately babies born to mothers who are hepatitis B positive, and follow-up accordingly
  • be aware that the UK has a selective immunisation programme for hepatitis B

Hepatitis C

Afghanistan has a considerably higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C.

Polio

Polio is endemic in Afghanistan, so:

  • be alert for signs and symptoms of polio in anyone arriving from Afghanistan, and investigate as appropriate
  • ensure all new entrants are brought up to date with the UK immunisation schedule, including polio vaccine as required
  • See NaTHNaC for advice about polio vaccine requirements if patients are planning to travel back to Afghanistan, as specific recommendations are in place for long-term visitors (over 4 weeks) to Afghanistan

Travel plans and advice

Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin, and see National Travel Health Network and Centre (NaTHNaC), or the Health Protection Scotland websites (TRAVAX and fitfortravel), for travel advice.

Malaria

There is a risk of malaria in some areas of Afghanistan, due to P. falciparum and P. vivax, so:

Typhoid

There is a risk of typhoid infection in Afghanistan, so:

  • ensure that travellers to Afghanistan are offered typhoid immunisation and advice on prevention of enteric fever
  • remember enteric fever in the differential diagnosis of illness in patients with a recent history of travel to-or-from Afghanistan

Helminths

There is a risk of helminth infections in Afghanistan, including soil transmitted helminthiasis.

Women’s health

Reproductive health indicators

Reproductive health indicator UK Afghanistan
Children per woman¹ 2 7
Use of contraception² 82% 10.3%

¹lifetime average ²by woman of reproductive age or partner

No data are available on:

  • mammography screening rates
  • cervical cancer screening rates


Find out more about women’s health.

Nutritional and metabolic concerns

Anaemia

There is a moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20 to 40%) and a high risk in pre-school children (estimated prevalence is > 40%) in Afghanistan, so:

  • consider the possibility of anaemia in recently arrived migrants, particularly women and pre-school children
  • test as clinically indicated

Vitamin D

Consider the possibility of vitamin D deficiency in people who may be at risk due to:

  • covering their body for cultural or religious reasons (lack of sunlight)
  • skin colour
  • diet (vegan or vegetarian)

Vitamin A

There is a high risk of vitamin A deficiency in Afghanistan.

Country profile

Health indicators and health care

WHO Global Health Observatory has a summary of health indicators and health care in Afghanistan.

Culture, politics and history

BBC News and The World Factbook provide background information on the culture, politics and history of Afghanistan.

Languages

Language Population (%)
Afghan Persian or Dari¹ 50
Pashto¹ 35
Turkic² 11
Minor³ 4

¹official; Dari functions as the lingua franca, although there is much bilingualism ²primarily Uzbek and Turkmen ³around 30, primarily Balochi and Pashai

Source: The World Factbook.


Find out about language interpretation.

Religions

Religion Population (%)
Sunni Muslim 80
Shia Muslim 19
Other 1

Source: The World Factbook.

Migration to the UK

There were almost 63,000 people from Afghanistan living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics © Crown Copyright 2014.

Published 31 July 2014
Last updated 7 April 2016 + show all updates
  1. Updated advice for hep B, malaria, and anaemia screening, based on current prevalence in Afghanistan.
  2. First published.