Tunisia: migrant health guide
Advice and guidance on the health needs of migrant patients from Tunisia for healthcare practitioners.
Main messages
If the patient is new to the UK:
- explain to them how the NHS works and their entitlements to healthcare
- discuss how this compares to the healthcare system they’ve been used to
- follow guidance on how to comprehensively assess new migrant patients
- ensure that they are up to date with the UK immunisation schedule
- ask about any travel plans the patient may have to visit friends and relatives in their country of origin
Due to an intermediate prevalence, consider screening for hepatitis B, particularly among those who have recently arrived.
There is a risk of typhoid infection.
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 low incidence of TB (less than 40 cases per 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:
- test all sexually active patients under the age of 25 for chlamydia
- screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
There is a low rate of HIV (less than or equal to 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
Hepatitis B
There is an intermediate prevalence of hepatitis B, so:
- consider screening for hepatitis B, particularly for those who have recently arrived
- offer screening for hepatitis B to all pregnant women during each pregnancy
- appropriately immunise babies born to mothers who are hepatitis B positive and follow up accordingly
- be aware that the UK has a a universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
Hepatitis C
The prevalence of hepatitis C is higher than the UK, so consider screening for hepatitis C if other risk factors apply.
Typhoid
There is a risk of typhoid infection, so:
- ensure that travellers 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 this country
Travel plans and advice
Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin. People who travel to visit friends and relatives (VFR travellers) should visit the Foreign and Commonwealth Office for overseas travel advice and National Travel Health Network and Centre (NaTHNaC) for country specific travel advice prior to leaving the UK.
Women’s health
Reproductive health indicators - UK and Tunisia
| Reproductive health indicator | UK | Tunisia |
|---|---|---|
| Number of children per woman (lifetime average) | 1.6 | 2.1 |
| Use of contraception (by woman of reproductive age or partner) | 71.7% | 50.7% |
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 pre-school children (estimated prevalence is 20 to 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:
- darker skin
- not spending much time outdoors
- covering up most of their skin when outdoors
Vitamin A
There may be a risk of vitamin A deficiency.
Country profile
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Tunisia.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Tunisia.
Languages
Languages used in Tunisia include:
- Arabic: official, one of the languages of commerce
- French: commerce
- Berber (Tamazight)
To note, despite having no official status French plays a major role in the country and is spoken by approximately two-thirds of the population.
Source: The World Factbook
Religions
| Religion | Population (%) |
|---|---|
| Muslim (official Sunni) | 99 |
| Other (other (includes Christian, Jewish, Shia Muslim, and Baha’i) | less than 1 |
Source: The World Factbook
Migration to the UK
There were almost 6,000 people from Tunisia living in England and Wales at the time of the 2011 Census.
Last updated 12 April 2023 + show all updates
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Updated the vitamin D deficiency risk groups.
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First published.