Guidance

Syria: migrant health guide

Advice and guidance on the health needs of migrant patients from Syria 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, because Syria has an intermediate prevalence.

Be alert for signs and symptoms of polio, and ensure vaccination as required, because polio (wild polio or cVDPV) has been reported in the past in Syria and the country remains vulnerable to reinfection.

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 risk of typhoid infection in Syria.

Find out more about children’s health.

Infectious diseases

Immunisation

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

Tuberculosis (TB)

There is a low incidence of TB in Syria (<40 cases per 100,000), so:

  • routine screening 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

Syria 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

Syria has an intermediate 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

No data are available on the prevalence of hepatitis C in Syria, so take other risk factors into consideration when assessing likely health needs in this area.

Polio

Polio (wild polio or cVDPV) has been reported in the past in Syria, and the country remains vulnerable to reinfection so:

  • be alert for signs and symptoms of polio in anyone arriving from Syria, and investigate as appropriate
  • ensure all new entrants are brought up to date with the UK immunisation schedule, including polio vaccine as required
  • see NaTHNaC for advice about polio vaccine requirements if patients are planning to travel back to Syria, as specific advice is in place for long-term visitors (over 4 weeks) to Syria.

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

Typhoid

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

  • ensure that travellers to Syria 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 Syria

Helminth

There is a risk of helminth infections in Syria, including soil transmitted helminthiasis.

Women’s health

Reproductive health indicators

Reproductive health indicator UK Syria
Children per woman¹ 2 3
Use of contraception² 82% 58.3%

¹lifetime average ²by woman of reproductive age or partner

No data are available on:

  • mammography screening rates
  • cervical cancer screening rates


Find out more about women’s health.

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 in pre-school children (estimated prevalence is 20 to 40%), in Syria, so:

  • consider 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 Syria.

Country profile

Health indicators and health care

WHO Global Health Observatory has a summary of health indicators and health care in Syria.

Culture, politics and history

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

Languages

The main languages used in Syria are:

  • Arabic (official)
  • Kurdish
  • Armenian
  • Aramaic
  • Circassian (widely understood)
  • French
  • English (somewhat understood)

Source: The World Factbook.


Find out about language interpretation.

Religions

Religion Population (%)
Muslim¹ 87
Christian² 10
Druze 3

¹official; includes: Sunni 74%; and Alawi, Ismaili and Shia 13% ²includes: Orthodox, Uniate, and Nestorian

Source: The World Factbook.

Migration to the UK

There were almost 9,000 people from Syria 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 24 May 2019 + show all updates
  1. Updated polio guidance.

  2. Updated advice on STI and anaemia risks, based on current prevalences in Syria.

  3. First published.