Central African Republic: migrant health guide
Advice and guidance on the health needs of migrant patients from Central African Republic 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. Central African Republic has an intermediate prevalence.
Consider screening for hepatitis C, because Central African Republic has a considerably higher prevalence than the UK.
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 Central African Republic and the country remains vulnerable to reinfection.
Ask 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 high risk of malaria in Central African Republic.
There is a risk of typhoid infection in Central African Republic.
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 Central African Republic (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 Central African Republic (>1%), so:
- offer and recommend an HIV test to all adults according to UK national testing guidelines.
- consider offering an HIV test to infants and children who have recently arrived in the UK according to UK national testing guidelines
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 Central African Republic 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
Central African Republic 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 universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
Hepatitis C
Central African Republic has a considerably higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C.
Polio
Polio (wild polio or cVDPV) has been reported in the past in Central African Republic and the country remains vulnerable to reinfection, so:
- be alert for signs and symptoms of polio in anyone arriving from Central African Republic, 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 Central African Republic, as specific advice is in place for long-term visitors (over 4 weeks) to Central African Republic
Travel plans and advice
Ask 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 high risk of malaria in Central African Republic, mainly due to P. falciparum, so:
- test any unwell patient who has travelled to-and-from affected areas of Central African Republic in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a risk of typhoid infection in Central African Republic, so:
- ensure that travellers to Central African Republic 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 Central African Republic
Helminths
There is a risk of helminth infections in Central African Republic, including:
- schistosomiasis
- lymphatic filariasis
- soil transmitted helminthiasis
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Central African Republic |
|---|---|---|
| Number of children per woman¹ | 2 | 5 |
| Use of contraception² | 82% | 27.9% |
¹lifetime average; ²by woman of reproductive age or partner
No data are available on:
- mammography screening rates
- cervical cancer screening rates
Female genital mutilation (FGM)
Healthcare practitioners are advised that FGM has regularly been documented in Central African Republic.
Nutritional and metabolic concerns
Anaemia
There is a high risk of anaemia in adults (estimated prevalence in non-pregnant women is >40%) and 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:
- 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 Central African Republic.
Iodine
People from Central African Republic may be at risk of moderate iodine deficiency due to inadequate intake.
Country profile
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Central African Republic.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Central African Republic.
Languages
The main languages used in Central African Republic are:
- French (official)
- Sangho (lingua franca and national language)
- Tribal languages
Source: The World Factbook.
Religions
| Religion | Population (%) |
|---|---|
| Indigenous beliefs | 35 |
| Protestant | 25 |
| Roman Catholic | 25 |
| Muslim | 15 |
Source: The World Factbook.
Migration to the UK
There were over 100 people from Central African Republic living in England and Wales at the time of the 2011 Census.
Source: Office for National Statistics.
Updates to this page
Last updated 24 May 2019 + show all updates
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Updated polio guidance.
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First published.