Guidance

Cuba: migrant health guide

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

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

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 low incidence of TB in Cuba (<40 cases/100,000), so:

  • routine screening for TB is not required
  • consider testing in patients (including children) who show signs and symptoms
  • 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

Cuba 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

Cuba 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

Cuba 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 Cuba, so:

  • ensure that travellers to Cuba 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 Cuba

Helminths

There is a risk of helminth infections in Cuba, including soil transmitted helminthiasis.

Women’s health

Reproductive health indicators

Reproductive health indicator UK Cuba
Number of children per woman¹ 2 2
Use of contraception² 82% 73.3%

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

No data are available on:

  • 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)

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

The main language used in Cuba is:

  • Spanish

Source: The World Factbook

Religions

The main religions in Cuba are:

  • Roman Catholic (nominally 85%)
  • Protestant
  • Jehovah’s Witness
  • Jewish
  • Santeria

Source: The World Factbook

Migration to the UK

There were almost 2,000 people from Cuba living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics

Published 31 July 2014