Guidance

Dominica: migrant health guide

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

Offer and recommend an HIV test to all adults from Dominica, and consider offering an HIV test to infants and children who have recently arrived in the UK.

Offer to all sexually active individuals:

  • a full sexual health screen
  • safer sex health promotion advice

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

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 Dominica (<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

There is a high rate of HIV in Dominica (>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 Dominica 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

Dominica 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

Dominica 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 Dominica, so:

  • ensure that travellers to Dominica 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 Dominica

Helminths

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

Women’s health

Reproductive health indicators

Reproductive health indicator UK Dominica
Number of children per woman¹ 2 2

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

No data are available on:

  • contraceptive use
  • 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 Dominica.

Culture, politics and history

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

Languages

The main languages used in Dominica are:

  • English (official)
  • French patois

Source: The World Factbook.

Religions

Religion Population (%)
Roman Catholic 61.4
Protestant¹ 20.6
Jehovah’s Witness 1.2
Other Christian 7.7
Rastafarian 1.3
Other or unspecified 1.6
None 6.1

¹includes Seventh-Day Adventist 6%, Pentecostal 5.6%, Baptist 4.1%, Methodist 3.7%, Church of God 1.2%

Source: The World Factbook.

Migration to the UK

There were almost 6,000 people from Dominica living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics.

Published 31 July 2014