Guidance

Guinea-Bissau: migrant health guide

Advice and guidance on the health needs of migrant patients from Guinea-Bissau 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).

Offer and recommend an HIV test to all adults from Guinea-Bissau, 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. Guinea-Bissau has a high prevalence.

Consider screening for hepatitis C, because Guinea-Bissau has a considerably higher prevalence 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.

There is a high risk of malaria in Guinea-Bissau.

There is a risk of typhoid infection in Guinea-Bissau.

Female genital mutilation (FGM) has been estimated to affect more than 30% of women and girls in Guinea-Bissau.

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 Guinea-Bissau (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

There is a high rate of HIV in Guinea-Bissau (>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 Guinea-Bissau 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

Guinea-Bissau has a high 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

Guinea-Bissau 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 high risk of malaria in Guinea-Bissau, mainly due to P. falciparum, so:

Typhoid

There is a risk of typhoid infection in Guinea-Bissau, so:

  • ensure that travellers to Guinea-Bissau 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 Guinea-Bissau

Helminths

There is a risk of helminth infections in Guinea-Bissau, including:

  • schistosomiasis
  • lymphatic filariasis
  • soil transmitted helminthiasis

Women’s health

Reproductive health indicators

Reproductive health indicator UK Guinea-Bissau
Number of children per woman¹ 2 7
Use of contraception² 82% 7.6%

¹lifetime average; ²by woman of reproductive age or partner

No data are available on:

  • contraceptive use
  • number of children per woman
  • mammography screening rates
  • cervical cancer screening rates

Female genital mutilation

Female genital mutilation (FGM) has been estimated to affect more than 30% of women and girls in Guinea-Bissau, so be advised that:

  • children born in the UK may be at risk of FGM during visits to friends and relatives in Guinea-Bissau
  • 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 Guinea-Bissau

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 high risk of anaemia in adults (estimated prevalence in non-pregnant women is >40%) and 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 high risk of vitamin A deficiency in Guinea-Bissau.

Country profile

Health indicators and health care

WHO Global Health Observatory has a summary of health indicators and health care in Guinea-Bissau.

Culture, politics and history

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

Languages

The main languages used in Guinea-Bissau are:

  • Portuguese (official)
  • Crioulo
  • African languages

Source: The World Factbook

Religions

Religion Population (%)
Muslim 50
Indigenous beliefs 40
Christian 10

Source: The World Factbook

Migration to the UK

There were over 2,000 people from Guinea-Bissau living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics

Published 31 July 2014