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.
Consider nutritional and metabolic concerns.
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:
- offer and recommend an HIV test according to UK national testing guidelines
- consider offering an HIV test to infants and children who have recently arrived in the UK according to UK national testing guidelines
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 universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
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:
- test any unwell patient who has travelled to-and-from affected areas of Liberia in the last year
- remember that malaria can be rapidly fatal
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.
Last updated 8 April 2016 + show all updates
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Updated advice on prevalence of FGM in Liberia.
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First published.