Guidance

Singapore: migrant health guide

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

Consider screening for hepatitis B, particularly among those who have recently arrived. Singapore has an intermediate prevalence.

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 typhoid infection in Singapore.

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 low incidence of TB in Singapore (<40 cases/100,000), so:

  • routine screening for TB is not required
  • consider testing in patients (including children) who show signs and symptoms
  • 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

Singapore 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

Singapore 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

Singapore has the same or lower prevalence of hepatitis C than the UK, so ascertain any risk factors for HCV infection that may indicate the need for screening.

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 very low risk of malaria in Singapore, mainly due to P. falciparum and P. vivax., so:

Typhoid

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

  • ensure that travellers to Singapore 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 Singapore

Women’s health

Reproductive health indicators

Reproductive health indicator UK Singapore
Children per woman¹ 2 1

¹lifetime average

No data are available on:

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

Nutritional and metabolic concerns

Anaemia

There is a moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20 to 40%) and a mild risk in pre-school children (estimated prevalence 5 to 20%), 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)

Health indicators and health care

WHO Global Health Observatory has a summary of health indicators and healthcare in Singapore.

Culture, politics and history

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

Languages

Language Population (%)
Mandarin (official) 36.3
English (official) 29.8
Malay (official) 11.9
Hokkien 8.1
Tamil (official) 4.4
Cantonese 4.1
Teochew 3.2
Other Indian languages 1.2
Other Chinese dialects 1.1
Other 1.1

Source: The World Factbook

Religions

Religion Population (%)
Buddhist 33.9
Muslim 14.3
Taoist 11.3
Catholic 7.1
Hindu 5.2
Other Christian 11
Other 0.7
None 16.4

Source: The World Factbook

Migration to the UK

There were almost 39,000 people from Singapore living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics

Published 31 July 2014