Advice and guidance on the health needs of migrant patients from Brunei Darussalam for healthcare practitioners.
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).
Consider screening for hepatitis B, particularly among those who have recently arrived. Brunei Darussalam has an intermediate prevalence.
Consider screening for hepatitis C, because Brunei Darussalam has a considerably higher prevalence than the UK.
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 high risk of typhoid infection in Brunei Darussalam.
Consider nutritional and metabolic concerns.
There is a high incidence of TB in Brunei Darussalam (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
Brunei Darussalam 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 universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
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.
There is a very low risk of malaria in Brunei Darussalam, due to P. falciparum and P. vivax, so:
- test any unwell patient who has travelled to-and-from affected areas of Brunei Darussalam in the last year
- remember that malaria can be rapidly fatal
There is a high risk of typhoid infection in Brunei Darussalam, so:
- ensure that travellers to Brunei Darussalam 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 Brunei Darussalam
Reproductive health indicators
|Reproductive health indicator||UK||Brunei Darussalam|
|Number of children per woman¹||2||2|
No data are available on:
- contraceptive use
- mammography screening rates
- cervical cancer screening rates
Nutritional and metabolic concerns
There is a moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20 to 40%) and a mild risk in pre-school children (estimated prevalence 5 to 20%), so:
- be alert to the possibility of anaemia in recently arrived migrants, particularly women and pre-school children
- test as clinically indicated
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)
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Brunei Darussalam.
Culture, politics and history
The main languages used in Brunei Darussalam are:
- Malay (official)
Source: The World Factbook.
¹2011 est. ²official; ³includes indigenous beliefs
Source: The World Factbook
Migration to the UK
There were almost 5,000 people from Brunei Darussalam living in England and Wales at the time of the 2011 Census.