Ethiopia: migrant health guide
Advice and guidance on the health needs of migrant patients from Ethiopia 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) from this country for tuberculosis (TB).
There is a high incidence of Multi Drug Resistant Tuberculosis (MDR-TB) in Ethiopia.
Consider screening for hepatitis B, particularly among those who have recently arrived. Ethiopia has an intermediate prevalence.
Ask 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 Ethiopia.
There is a risk of typhoid infection in Ethiopia.
Female genital mutilation (FGM) has been estimated to affect more than 60% of women and girls in Ethiopia.
Consider nutritional and metabolic concerns.
Find out more about children’s health.
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 Ethiopia is very high (>500 cases/100,000), and there is also a high burden of MDR-TB, so:
- screen all new entrants, including children, for TB according to NICE guidelines
- refer to TB services promptly if screening is positive
- seek advice, if you are a local TB service, from the MDR-TB Clinical Advice Service before treating patients from Ethiopia for TB
- 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
Ethiopia 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
Ethiopia 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
Ethiopia 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 Ethiopia, due to P. falciparum and P. vivax, so:
- test any unwell patient who has travelled to-and-from affected areas of Ethiopia in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a risk of typhoid infection in Ethiopia, so:
- ensure that travellers to Ethiopia 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 Ethiopia
Helminths
There is a risk of helminth infections in Ethiopia, including:
- schistosomiasis
- lymphatic filariasis
- soil transmitted helminthiasis
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Ethiopia |
|---|---|---|
| Number of children per woman¹ | 2 | 5 |
| Use of contraception² | 82% | 14.7% |
| Breast examination or mammography³ | 75% | 1% |
| Cervical cancer screening⁴ | 70% | 1% |
¹lifetime average; ²by woman of reproductive age or partner; ³women aged 50 to 69 years; ⁴women aged 20 to 69 years
Find out more about women’s health.
Female genital mutilation
Female genital mutilation (FGM) has been estimated to affect more than 60% of women and girls in Ethiopia, so be advised that:
- children born in the UK may be at risk of FGM during visits to friends and relatives in Ethiopia
- it is illegal to take girls who are British nationals or permanent residents of the UK abroad for FGM, whether or not it is lawful in Ethiopia
If you are concerned that a British citizen may be taken overseas for the purpose of FGM, please call the Foreign and Commonwealth Office on 020 7008 1500 or email fgm@fco.gov.uk.
Nutritional and metabolic concerns
Anaemia
There is a low risk of anaemia in adults (estimated prevalence is 5 to 20%) and a high risk in pre-school children (estimated prevalence is >40%), so:
- be alert to this possibility in recently arrived migrants, particularly for 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)
Country profile
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Ethiopia.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Ethiopia.
Languages
| Language | Population (%) |
|---|---|
| Oromo¹ | 33.8 |
| Amharic (official national language) | 29.3 |
| Somali² | 6.2 |
| Tigrigna (Tigrinya)³ | 5.9 |
| Sidamo | 4 |
| Wolaytta | 2.2 |
| Gurage | 2 |
| Afar⁴ | 1.7 |
| Hadiyya | 1.7 |
| Gamo | 1.5 |
| Gedeo | 1.3 |
| Opuuo | 1.2 |
| Kafa | 1.1 |
| Other | 8.1 |
Arabic and English (major foreign language taught in schools) are also spoken but no percentages are available for these languages.
¹official working language in the State of Oromiya; ²official working language of the State of Sumale; ³official working language of the State of Tigra; ⁴ official working language of the State of Afar
Source: The World Factbook.
Find out about language interpretation.
Religions
| Religion | Population (%) |
|---|---|
| Ethiopian Orthodox | 43.5 |
| Muslim | 33.9 |
| Protestant | 18.5 |
| Traditional | 2.7 |
| Catholic | 0.7 |
| Other | 0.6 |
Source: The World Factbook.
Migration to the UK
There were almost 15,000 people from Ethiopia 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 as Ethiopia now has a low HIV prevalence (<1%) according to latest UNAIDS data.
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Updated and made editorial changes to meet GOV.UK style.
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First published.