Guidance

Belarus: migrant health guide

Advice and guidance on the health needs of migrant patients from Belarus 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).

There is a high burden of multi drug resistant tuberculosis (MDR - TB) in Belarus.

Consider screening for hepatitis B, particularly among those who have recently arrived, because Belarus has an intermediate prevalence.

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.

There is a risk of typhoid infection in Belarus.

Infectious diseases

Immunisation

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

Tuberculosis (TB)

The incidence of TB in Belarus is high (40 to 499 cases/100,000) and there is also a high burden of Multi Drug Resistant (MDR) TB, so:

  • screen all new entrants (including children) from (country) for TB according to NICE guidelines
  • refer to TB services promptly if screening is positive
  • seek advice, if you are a local TB service, from the MDR-TB Clinical Advice Service before treating patients from Bangladesh for TB
  • 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 (STIs) 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

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

  • offer and recommend a 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

Belarus has an intermediate prevalence of hepatitis B, so:

  • consider screening for hepatitis B, particularly those who have recently arrived
  • 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

Belarus has a higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C if other risk factors apply.

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.

Typhoid

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

  • ensure that travellers to Belarus 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 Belarus

Women’s health

Reproductive health indicators

Reproductive health indicator UK Belarus
Children per woman¹ 2 1

¹lifetime average

No data are available on:

  • contraceptive use
  • mammography screening rates
  • cervical cancer screening rates

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 pre-school children (estimated prevalence is 20 to 40%), so:

  • be alert to 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 risk of vitamin A deficiency in Belarus.

Iodine

People from Belarus may be at risk of moderate iodine deficiency due to inadequate intake.

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

The main languages used in Belarus are:

Language Population (%)¹
Belarusian (official) 23.4
Russian (official) 70.2
Other² 3.1
Unspecified 3.3

¹2012 est.²includes small Polish- and Ukrainian-speaking minorities

Source: The World Factbook.

Religions

Religion Population (%)¹
Eastern Orthodox 89.5
Other² 9.6

¹2012 est.²including Roman Catholic, Protestant, Jewish, and Muslims

Source: The World Factbook.

Migration to the UK

There were almost 4,000 people from Belarus living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics

Published 31 July 2014