Guidance

Ecuador: migrant health guide

Advice and guidance on the health needs of migrant patients from Ecuador 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. Ecuador 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 high risk of malaria in some areas of Ecuador.

There is a risk of typhoid infection in Ecuador.

Be alert for possible cases of Chagas disease, and refer as appropriate, because there is a risk of chronic Chagas disease in migrants from Ecuador.

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 high incidence of TB in Ecuador (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

Ecuador 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

Ecuador 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

Ecuador 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.

Malaria

There is a high risk of malaria in some areas of Ecuador, due to P. falciparum and P. vivax, so:

Typhoid

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

  • ensure that travellers to Ecuador 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 Ecuador

Helminths

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

Chagas

There is a risk of chronic Chagas disease in migrants from Ecuador, so:

  • be alert for possible cases
  • refer as appropriate

Women’s health

Reproductive health indicators

Reproductive health indicator UK Ecuador
Number of children per woman¹ 2 3
Use of contraception² 82% 72.7%
Breast examination or mammography³ 75% 17%
Cervical cancer screening⁴ 70% 45%

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 a high risk in pre-school children (estimated prevalence is >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)

Vitamin A

There is a risk of vitamin A deficiency in Ecuador.

Iodine

People from Ecuador may be at risk of adverse health consequences due to excessive intake of iodine.

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

Language Population (%)
Spanish (Castillian) (official) 93
Quechua¹ 4.1
Other indigenous 0.7
Foreign 2.2

¹Quechua and Shuar are official languages of intercultural relations

Source: The World Factbook.

Religions

Religion Population (%)
Roman Catholic 95
Other 5

Source: The World Factbook.

Migration to the UK

There were almost 9,000 people from Ecuador living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics.

Published 31 July 2014