Guidance

Yemen: migrant health guide

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

Consider screening for hepatitis B, particularly among those who have recently arrived, because Yemen has a high prevalence.

Consider screening for hepatitis C, because Yemen 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 risk of malaria in some areas of Yemen.

Be advised that there is a risk of typhoid infection in Yemen.

Be aware that female genital mutilation (FGM) has been estimated to affect more than 30% of women and girls in Yemen.

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 Yemen (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

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

Yemen 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

Yemen 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

Yemen 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 risk of malaria in some areas of Yemen, mainly due to P. falciparum, so:

Typhoid

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

  • ensure that travellers to Yemen 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 Yemen

Helminths

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

  • schistosomiasis
  • soil transmitted helminthiasis

Women’s health

Reproductive health indicators

Reproductive health indicator UK Yemen
Children per woman¹ 2 6
Use of contraception² 82% 23.1%

¹lifetime average ²by woman of reproductive age or partner

No data are available on:

  • mammography screening rates
  • cervical cancer screening rates

Female genital mutilation

Female genital mutilation (FGM) has been regularly documented in Yemen, so be advised that:

  • children born in the UK may be at risk of FGM during visits to friends and relatives in Yemen
  • 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 Yemen

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 moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20 to 40%), and a high-risk in pre-school children (estimated prevalence is >40%), in Yemen, 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 risk of vitamin A deficiency in Yemen.

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

Arabic is the official language of Yemen.

Source: The World Factbook.

Religions

Religion Population (%)¹
Muslim² 99.1
Other³ 0.9

¹2010 est. ²official; virtually all are citizens, an estimated 65% are Sunni and 35% are Shia ³includes Jewish, Baha’i, Hindu, and Christian; many are refugees or temporary foreign residents

Source: The World Factbook.

Migration to the UK

There were almost 18,000 people from Yemen 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 18 April 2016 + show all updates
  1. Updated advice on risks of hep B, helminths, anaemia and FGM based on current prevalences in Yemen.
  2. First published.