Dominican Republic: migrant health guide
Advice and guidance on the health needs of migrant patients from the Dominican Republic for healthcare practitioners.
Main messages
If the patient is new to the UK:
- explain to them how the NHS works and their entitlements to healthcare
- discuss how this compares to the healthcare system they’ve been used to
- follow guidance on how to comprehensively assess new migrant patients
- ensure that they are up to date with the UK immunisation schedule
- ask about any travel plans the patient may have to visit friends and relatives in their country of origin
Screen all new entrants, including children, for tuberculosis (TB).
The prevalence of human T-lymphotropic virus (HTLV) is high.
Due to an intermediate prevalence, consider screening for hepatitis B, particularly among those who have recently arrived.
Consider screening for hepatitis C because of a considerably higher prevalence than the UK.
There is a risk of typhoid infection.
Consider nutritional and metabolic concerns.
Infectious diseases
Immunisation
Ensure that all patients, especially children, are up to date with the UK immunisation schedule.
Tuberculosis
There is a high incidence of tuberculosis (TB) (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
Take a sexual history, and:
- screen for sexually transmitted infections (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
There is a low rate of HIV (less than 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
HTLV
The prevalence of human T-cell lymphotropic virus (HTLV) is high. Refer to further HTLV guidance about testing and treatment.
Hepatitis B
There is 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 a universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
Hepatitis C
The prevalence of hepatitis C is higher than the UK, so consider screening for hepatitis C if other risk factors apply.
Malaria
There is a low risk of malaria, in some areas, due to P. falciparum, so:
- test any unwell patient who has travelled to and from affected areas in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a risk of typhoid infection, so:
- ensure that travellers 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 this country
Helminths
There is a risk of soil transmitted helminth infections.
Travel plans and advice
Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin. People who travel to visit friends and relatives (VFR travellers) should visit the Foreign and Commonwealth Office for overseas travel advice and National Travel Health Network and Centre (NaTHNaC) for country specific travel advice prior to leaving the UK.
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Dominican Republic |
|---|---|---|
| Number of children per woman (lifetime average) | 1.6 | 2.3 |
| Use of contraception (by woman of reproductive age or partner) | 71.7% | 56.4% |
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 in pre-school children (estimated prevalence is 20 to 40%), in the Dominican Republic, so:
- consider 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:
- darker skin
- those who are not often outdoors
- those who cover up most of their skin when outdoors
Vitamin A
There may be a risk of vitamin A deficiency.
Iodine
There may be a risk of of moderate iodine deficiency due to inadequate intake
Country profile
Health indicators and healthcare
WHO Global Health Observatory has a summary of health indicators and healthcare in the Dominican Republic.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of the Dominican Republic.
Languages
Spanish is the official language of the Dominican Republic.
Source: The World Factbook.
Religions
| Religion | Population (%) (2018 estimates) |
|---|---|
| Roman Catholic | 44.3 |
| Evangelical | 13 |
| Protestant | 7.9 |
| Adventist | 1,4 |
| Other | 1.8 |
| Atheist | 0.2 |
| None | 29.4 |
| Unspecified | 2 |
Source: The World Factbook.
Migration to the UK
There were over 8,800 people from the Dominican Republic living in England and Wales at the time of the 2021 Census.
Last updated 22 May 2023 + show all updates
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Women's reproductive health indicators data, vitamin D deficiency risk groups and the proportions of the population by different religions have been updated.
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Updated advice on testing for malaria, based on current prevalence in Dominican Republic.
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First published.