Guidance

Liberia: migrant health guide

Advice and guidance on the health needs of migrant patients from Liberia 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.

Be aware that there has been an outbreak of Ebola in Liberia.

Screen all new entrants, including children, for tuberculosis (TB).

Offer and recommend an HIV test to all adults from Liberia, 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, because Liberia has a high prevalence.

Consider screening for hepatitis C, because Liberia 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.

Be advised that there is a high risk of malaria in Liberia.

Be advised that there is a risk of typhoid infection in Liberia.

Be aware that female genital mutilation (FGM) has been estimated to affect more than 60% of women and girls in Liberia.

Infectious diseases

Immunisation

Ensure that all patients, especially children, are up-to-date with the UK immunisation schedule.

Tuberculosis (TB)

There is a high incidence of TB in Liberia (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 Liberia (>1%), so:

Be advised that 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 Liberia 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

Liberia 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

Liberia 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 Liberia, mainly due to P. falciparum, so:

Typhoid

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

  • ensure that travellers to Liberia 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 Liberia

Helminths

There is a risk of helminth infections in Liberia, including:

  • schistosomiasis
  • lymphatic filariasis
  • soil transmitted helminthiasis

Women’s health

Reproductive health indicators

Reproductive health indicator UK Liberia
Children per woman¹ 2 7

¹lifetime average

No data are available on:

  • contraceptive use
  • mammography screening rates
  • cervical cancer screening rates

Female genital mutilation

Female genital mutilation (FGM) has been estimated to affect more than 60% of women and girls in Liberia, so be advised that:

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

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 in pre-school children (estimated prevalence is >40%), in Liberia, 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 Liberia.

Iodine

People from Liberia 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 Liberia.

Culture, politics and history

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

Languages

The main languages used in Liberia are:

  • English (official; 20%)
  • 20 ethnic group languages, few of which can be written or used in correspondence

Source: The World Factbook.

Religions

Religion Population (%)¹
Christian 85.6
Muslim 12.2
None 1.4
Traditional 0.6
Other 0.2

¹2008 Census

Source: The World Factbook.

Migration to the UK

There were over 3,000 people from Liberia living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics © Crown Copyright 2014.

Published 31 July 2014
Last updated 8 April 2016 + show all updates
  1. Updated advice on prevalence of FGM in Liberia.
  2. First published.