Guidance

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 $CTAb

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.

Offer and recommend an HIV test to all adults from Estonia, 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. 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. $CTA

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

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

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 selective immunisation programme for hepatitis B

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.

Published 31 July 2014