Guidance

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
  • 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, because the Dominican Republic has an intermediate prevalence.

Consider screening for hepatitis C, because the Dominican Republic has a considerably higher prevalence of hepatitis C 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 risk of malaria in some areas of the Dominican Republic.

Be advised that there is a risk of typhoid infection in the Dominican Republic.

Infectious diseases

Immunisation

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

Tuberculosis (TB)

There is a high incidence of TB in the Dominican 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

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

The Dominican Republic 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

The Dominican Republic 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

The Dominican 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 risk of malaria in some areas of the Dominican Republic so:

Typhoid

There is a risk of typhoid infection in the Dominican Republic, so:

  • ensure that travellers to the Dominican 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 the Dominican Republic

Helminths

There is a risk of helminth infections in the Dominican Republic, including:

  • schistosomiasis
  • lymphatic filariasis
  • soil transmitted helminthiasis

Women’s health

Reproductive health indicators

Reproductive health indicator UK Dominican Republic
Children per woman¹ 2 3
Use of contraception² 82% 69.8%
Breast examination or mammography³ 75% 18%
Cervical cancer screening⁴ 70% 66%

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 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:

  • covering their body for cultural or religious reasons (lack of sunlight)
  • skin colour
  • diet (vegan or vegetarian)

Vitamin A

There is a risk of vitamin A deficiency in the Dominican Republic.

Iodine

People from the Dominican 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 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 (%)
Roman Catholic 95
Other 5

Source: The World Factbook.

Migration to the UK

There were over 1,000 people from the Dominican Republic 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, based on current prevalence in Dominican Republic.
  2. First published.