Estonia: migrant health guide
Advice and guidance on the health needs of migrant patients from Estonia 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.
There is a high burden of Multi Drug Resistant Tuberculosis (MDR-TB) in Estonia.
Consider screening for hepatitis B, particularly among those who have recently arrived. Estonia 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.
Consider nutritional and metabolic concerns.
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
The incidence of TB in Estonia is low (<40 cases/100,000), and there is also a high burden of MDR-TB, so:
- routine screening is not required
- consider testing for TB (including children) if the patient shows signs and symptoms
- seek advice, if you are a local TB service, from the MDR-TB Clinical Advice Service before treating patients from Estonia for TB
- 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
Estonia 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
Estonia 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 universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
Hepatitis C
Estonia 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 Estonia, so:
- ensure that travellers to Estonia 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 Estonia
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Estonia |
|---|---|---|
| Number of children per woman¹ | 2 | 2 |
| Breast examination or mammograph² | 75% | 39% |
| Cervical cancer screening³ | 70% | 53% |
¹ lifetime average; ²women aged 50 to 69 years;³women aged 20 to 69 years
No data are available on:
- contraceptive use
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)
Vitamin A
There may be a risk of vitamin A deficiency in Estonia.
Iodine
People from Estonia may be at risk of mild 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 Estonia.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Estonia.
Languages
| Language | Population (%) |
|---|---|
| Estonian (official) | 68.5% |
| Russian | 29.6% |
| Ukrainian | 0.6% |
| Other | 1.2% |
| Unspecified | 0.1% |
Source: The World Factbook.
Religions
| Religion | Population (%) |
|---|---|
| Lutheran | 9.9% |
| Orthodox | 16.2% |
| Other Christian | 2.2% |
| Other | 0.9% |
| None | 54.1% |
| Unspecified | 16.7% |
¹including Methodist, Seventh-Day Adventist, Roman Catholic, Pentecostal
Source: The World Factbook.
Migration to the UK
There were almost 8,000 people from Estonia living in England and Wales at the time of the 2011 Census.
Source: Office for National Statistics.
Last updated 7 June 2019 + show all updates
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Updated HIV guidance to low HIV prevalence (<1%) according to latest UNAIDS data.
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First published.