Guidance

China: migrant health guide

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

Be advised that there is a high burden of Multi Drug Resistant Tuberculosis (MDR-TB) in China.

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

Consider screening for hepatitis C, because China 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.

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

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

Infectious diseases

Immunisation

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

Tuberculosis (TB)

China has a high incidence of TB (40 to 499 cases per 100,000), and also a high burden of MDR-TB, so:

  • screen all new entrants (including children) 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 China 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 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

China 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

China 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

China 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 some areas of China, due to P. falciparum and P. vivax, so:

Typhoid

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

  • ensure that travellers to China 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 China

Helminths

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

  • schistosomiasis
  • soil transmitted helminthiasis

Women’s health

Reproductive health indicators

Reproductive health indicator UK China
Children per woman¹ 2 2
Use of contraception² 82% 90.2%
Breast examination or mammography³ 75% 16%
Cervical cancer screening⁴ 70% 21%

¹lifetime average ²by woman of reproductive age or partner ³women aged 50 to 69 years ⁴women aged 20 to 69 years

Nutritional and metabolic concerns

Anaemia

There is a low risk of anaemia in adults (estimated prevalence in non-pregnant women is 5 to 20%), and in pre-school children (estimated prevalence is 5 to 20%), in China, 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 China.

Iodine

People from China may be at risk of iodine induced hyperthyroidism due to excessive intake.

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

The main languages used in China include:

  • Standard Chinese or Mandarin (official: Putonghua, based on the Beijing dialect)
  • Yue (Cantonese)
  • Wu (Shanghainese)
  • Minbei (Fuzhou)
  • Minnan (Hokkien-Taiwanese)
  • Xiang
  • Gan
  • Hakka dialects
  • minority languages

Source: The World Factbook.

Religions

Religion Population (%)
Unaffiliated 52.2
Folk religion 21.9
Buddhist 18.2
Christian 5.1
Muslim 1.8
Other¹ 0.7
Hindu 0.1
Jewish 0.1

¹includes Daoist (Taoist)

Source: The World Factbook.

Migration to the UK

There were over 152,000 people from China 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 testing for malaria and anaemia, based on current prevalence in China.
  2. First published.