Guidance

Malaysia: migrant health guide

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

Ascertain any risk factors for hepatitis B infection that may indicate the need for screening, because Malaysia has a low prevalence.

Consider screening for hepatitis C, because Malaysia 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 some areas of Malaysia.

There is a high risk of typhoid infection in Malaysia.

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 (TB)

There is a high incidence of TB in Malaysia (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 (STIs) 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

Malaysia has a low rate of HIV (≤1%), so:

  • offer and recommend a 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

Malaysia has a low 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

Malaysia 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 some areas of Malaysia, due to P. falciparum and P. vivax. so:

Typhoid

There is a high risk of typhoid infection in Malaysia, so:

  • ensure that travellers to Malaysia 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 Malaysia

Helminths

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

  • lymphatic filariasis
  • soil transmitted helminthiasis

Women’s health

Reproductive health indicators

Reproductive health indicator UK Malaysia
Number of children per woman¹ 2 3
Breast examination or mammography² 75% 9%
Cervical cancer screening³ 70% 30%

¹lifetime average; ²women aged 50 to 69 years; ³women aged 20 to 69 years

No data is available on contraceptive use.

Nutritional and metabolic concerns

Anaemia

There is a moderate risk of anaemia in people from Malaysia (estimated prevalence in non-pregnant women is 20 to 40%) and a high risk in 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 Malaysia.

Iodine

People from Malaysia 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 Malaysia.

Culture, politics and history

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

Languages

The main languages used in Malaysia are:

  • Bahasa Malaysia (official)
  • English
  • Chinese¹
  • Tamil
  • Telugu
  • Malayalam
  • Panjabi
  • Thai

¹Cantonese, Mandarin, Hokkien, Hakka, Hainan, Foochow

Source: The World Factbook

Religions

Religion Population (%)
Buddhist 19.8
Christian 9.2
Hindu 6.3
Confucianism, Taoism, other traditional Chinese religions 1.3
Other 0.4
None 0.8
Unspecified 1

Source: The World Factbook

Migration to the UK

At the time of the 2011 census there were almost 65,000 people from Malaysia living in England and Wales. Source: Office for National Statistics

Published 31 July 2014