Guidance

Botswana: migrant health guide

Advice and guidance on the health needs of migrant patients from Botswana for healthcare practitioners.

From:
Public Health England
Published
31 July 2014
Last updated
26 August 2021 — See all updates

Main messages

If the patient is new to the UK:

Screen all new entrants, including children, for tuberculosis (TB).

Offer and recommend an HIV test to all adults from Botswana, and consider offering an HIV test to infants and children who have recently arrived in the UK.

Offer to all sexually active individuals:

  • a full sexual health screen
  • safer sex health promotion advice

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

Consider screening for hepatitis C, because Botswana has a considerably higher prevalence than the UK.

There is a risk of typhoid infection in Botswana.

There is a high risk of malaria in Botswana.

Consider nutritional and metabolic concerns.

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 high incidence of TB in Botswana (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

There is a high rate of HIV in Botswana (>1%), so:

Although recent global data on STIs are not available, countries with high HIV rates tend to have higher rates of STIs, and the range of STIs encountered in Botswana may vary from those in the UK, so offer to sexually active individuals:

  • a full sexual health screen
  • safer sex health promotion advice by referral to local genito-urinary medicine services

Hepatitis B

Botswana 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

Botswana has a considerably higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C.

Malaria

There is a high risk of malaria in some areas of Botswana, mainly due to P. falciparum, so:

  • test any unwell patient who has travelled to and from affected areas of Botswana in the last year
  • remember that malaria can be rapidly fatal

Typhoid

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

  • ensure that travellers to Botswana 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 Botswana

Helminths

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

  • schistosomiasis
  • soil transmitted helminthiasis

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.

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%), 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
  • those who are not often outdoors
  • those who cover up most of their skin when outdoors

Vitamin A

There is a high risk of vitamin A deficiency in Botswana.

Iodine

People from Botswana may be at risk of iodine induced hyperthyroidism due to excessive intake.

Women’s health

Reproductive health indicators

Reproductive health indicator UK Botswana
Number of children per woman¹ 1.7 2.8
Use of contraception² 71.7% 67.4%

¹lifetime average; ²by woman of reproductive age or partner

No data are available on:

  • mammography screening rates
  • cervical cancer screening rates

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

Language Population (%)
Setswana 77.3
Sekalanga 7.4
Shekgalagadi 3.4
English (official) 2.8
Zezuru/Shona 2
Sesarwa 1.7
Sembukushu 1.6
Ndebele 1
Other 2.8

Source: The World Factbook

Religions

Religion Population (%)
Christian 79.1
Badimo 4.1
Other¹ 1.4
None 15.2
Unspecified 0.3

¹includes Baha’i, Hindu, Muslim, Rastafarian

Source: The World Factbook

Migration to the UK

There were almost 3,000 people from Botswana living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics

Updates to this page

Published 31 July 2014
Last updated 26 August 2021 + show all updates

  1. Updated country guidance on prevalence of communicable diseases and other health topics.

  2. First published.

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