Guidance

Central African Republic: migrant health guide

Advice and guidance on the health needs of migrant patients from Central African Republic 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).

Consider screening for hepatitis B, particularly among those who have recently arrived. Central African Republic has an intermediate prevalence.

Consider screening for hepatitis C, because Central African Republic 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 malaria in Central African Republic.

There is a risk of typhoid infection in Central African Republic.

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

There is a high incidence of TB in Central African Republic (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

There is a high rate of HIV in Central African Republic (>1%), so:

Although recent global data on STIs are not available, countries with high HIV rates tend to have higher rates of STIs, and the range of STIs encountered in Central African Republic may vary from those in the UK, so offer to sexually active individuals:

  • a full sexual health screen
  • safer sex health promotion advice by referral to local genito-urinary medicine services.

Hepatitis B

Central African Republic has a high 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

Central African Republic 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 high risk of malaria in Central African Republic, mainly due to P. falciparum, so:

Typhoid

There is a risk of typhoid infection in Central African Republic, so:

  • ensure that travellers to Central African Republic 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 Central African Republic

Helminths

There is a risk of helminth infections in Central African Republic, including:

  • schistosomiasis
  • lymphatic filariasis
  • soil transmitted helminthiasis

Women’s health

Reproductive health indicators

Reproductive health indicator UK Central African Republic
Number of children per woman¹ 2 5
Use of contraception² 82% 27.9%

¹lifetime average; ²by woman of reproductive age or partner

No data are available on:

  • mammography screening rates
  • cervical cancer screening rates

Female genital mutilation (FGM)

Healthcare practitioners are advised that FGM has regularly been documented in Central African Republic.

Nutritional and metabolic concerns

Anaemia

There is a high risk of anaemia in adults (estimated prevalence in non-pregnant women is >40%) and pre-school children (estimated prevalence is >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 high risk of vitamin A deficiency in Central African Republic.

Iodine

People from Central African Republic 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 Central African Republic.

Culture, politics and history

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

Languages

The main languages used in Central African Republic are:

  • French (official)
  • Sangho (lingua franca and national language)
  • Tribal languages

Source: The World Factbook.

Religions

Religion Population (%)
Indigenous beliefs 35
Protestant 25
Roman Catholic 25
Muslim 15

Source: The World Factbook.

Migration to the UK

There were over 100 people from Central African Republic living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics.

Published 31 July 2014