Guidance

Brazil: migrant health guide

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

From:
Office for Health Improvement and Disparities
Published
31 July 2014
Last updated
11 April 2023 — See all updates

Main messages

If the patient is new to the UK:

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

The prevalence of human T-lymphotropic virus (HTLV) is high.

Due to a low prevalence, ascertain any risk factors for hepatitis B infection that may indicate the need for screening.

There is a risk of typhoid infection.

Be alert for possible cases of Chagas disease, and refer as appropriate, because there is a risk of chronic Chagas disease in migrants.

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 high incidence of TB (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:

  • 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 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

HTLV

The prevalence of human T-cell lymphotropic virus (HTLV) is high. Refer to further HTLV guidance about testing and treatment.

Hepatitis B

There is a low prevalence of hepatitis B, so:

  • 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 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 considerably higher than the UK, so consider screening for hepatitis C.

Malaria

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

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

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

Helminths

There is a risk of soil transmitted helminth infections.

Chagas disease

There is a risk of chronic Chagas disease in migrants from Brazil, so:

  • be alert for possible cases
  • refer as appropriate

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

Reproductive health indicator UK Brazil
Number of children per woman (lifetime average) 1.6 1.7
Use of contraception (by woman of reproductive age or partner) 71.7% 80.2%

Nutritional and metabolic concerns

Anaemia

There is a low risk of anaemia in adults (estimated prevalence is 5 to 20%) and a moderate risk in pre-school children (estimated prevalence is 20 to 40%) in Brazil, so:

  • be alert to this possibility in recently arrived migrants, particularly for 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.

Iodine

There may be a risk of risk of adverse health consequences due to excessive intake of iodine

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

Portuguese is the official and most widely spoken language. Less common languages include:

  • Spanish (border areas and schools)
  • German
  • Italian
  • Japanese
  • English
  • a large number of minor Amerindian languages

Source: The World Factbook.

Religions

Religion Population (%) (2010 estimates)
Roman Catholic 64.6
Protestant (includes: Adventist 6.5%, Assembly of God 2%, Christian Congregation of Brazil 1.2%, Universal Kingdom of God 1%, other Protestant 11.5%) 22.2
None 8
Spiritist 2.2
Other 1.4
Other Christian 0.7
Other Catholic 0.4
Unspecified 0.4

Source: The World Factbook, Brazil

Migration to the UK

There were almost 51,000 people from Brazil living in England and Wales at the time of the 2011 Census.

Updates to this page

Published 31 July 2014
Last updated 11 April 2023 + show all updates

  1. Updated the vitamin D deficiency risk groups.

  2. Added prevalence of HTLV-1 infection to the page.

  3. Updated advice on screening for malaria and anaemia, based on current prevalence in Brazil.

  4. First published.

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