Guidance

Brazil: migrant health guide

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

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

Consider screening for hepatitis C, because Brazil has a considerably higher prevalence of hepatitis C.

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 malaria in some areas of Brazil.

There is a risk of typhoid infection in Brazil.

Be alert for possible cases of Chagas disease and refer as appropriate, because there is a risk of chronic Chagas disease in migrants from Brazil.

Infectious diseases

Immunisation

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

Tuberculosis (TB)

Brazil has a high incidence of TB (40 to 499 cases per 100,000), so:

  • screen all new entrants 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

Brazil 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

Brazil 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

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

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 Brazil, due to P. falciparum and P. vivax, so:

Typhoid

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

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

Helminths

There is a risk of helminth infections in Brazil, including:

  • schistosomiasis
  • lymphatic filariasis
  • soil transmitted helminthiasis

Chagas disease

There is a risk of chronic Chagas disease in migrants from Brazil, so:

  • be alert for possible cases
  • refer as appropriate

Women’s health

Reproductive health indicators

Reproductive health indicator UK Brazil
Children per woman¹ 2 2
Breast examination or mammography² 75% 49%
Cervical cancer screening³ 70% 72%

¹lifetime average ²women aged 50 to 69 years ³women aged 20 to 69 years

No data are available on contraceptive use.

Nutritional and metabolic concerns

Anaemia

There is a low risk of anaemia in adults (estimated prevalence is 5 to 20%) and a moderate risk in pre-school children (estimated prevalence is 20 to 40%) in Brazil, so:

  • be alert to this possibility in recently arrived migrants, particularly for 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 Brazil.

Iodine

People from Brazil may be at risk of adverse health consequences due to excessive intake of iodine.

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

Portuguese is the official and most widely spoken language. Less common languages include:

  • Spanish (border areas and schools)
  • German
  • Italian
  • Japanese
  • English
  • a large number of minor Amerindian languages

Source: The World Factbook.

Religions

Religion Population (%)¹
Roman Catholic 64.6
Protestant² 22.2
None 8
Spiritist 2.2
Other 1.4
Other Christian 0.7
Other Catholic 0.4
Unspecified 0.4

¹2010 est. ²includes: Adventist 6.5%, Assembly of God 2%, Christian Congregation of Brazil 1.2%, Universal Kingdom of God 1%, other Protestant 11.5%

Source: The World Factbook.

Migration to the UK

There were almost 51,000 people from Brazil 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 on screening for malaria and anaemia, based on current prevalence in Brazil.
  2. First published.