Djibouti: migrant health guide
Advice and guidance on the health needs of migrant patients from Djibouti 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).
Offer and recommend an HIV test to all adults from Djibouti, 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. Djibouti has a high prevalence.
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 risk of typhoid infection in Djibouti.
Female genital mutilation (FGM) has been estimated to affect more than 80% of women and girls in Djibouti.
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 Djibouti (40 to 499 cases/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 Djibouti (>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 Djibouti 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
Djibouti 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
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 Djibouti, mainly due to P. falciparum., so:
- test any unwell patient who has travelled to-and-from affected areas of Djibouti in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a risk of typhoid infection in Djibouti, so:
- ensure that travellers to Djibouti 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 Djibouti
Helminths
There is a risk of helminth infections in Djibouti, including soil transmitted helminthiasis.
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Djibouti |
|---|---|---|
| Number of children per woman¹ | 2 | 4 |
| Use of contraception² | 82% | 17.8% |
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 estimated to affect more than 80% of women and girls in Djibouti, so be advised that:
- children born in the UK may be at risk of FGM during visits to friends and relatives in Djibouti
- 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 Djibouti
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 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:
- 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 Djibouti.
Country profile
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Djibouti.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Djibouti.
Languages
The main languages used in Djibouti are:
- French (official)
- Arabic (official)
- Somali
- Afar
Source: The World Factbook.
Religions
| Religion | Population (%) |
|---|---|
| Muslim | 94 |
| Christian | 6 |
Source: The World Factbook.
Migration to the UK
There were over 400 people from Djibouti living in England and Wales at the time of the 2011 Census.
Source: Office for National Statistics.
Updates to this page
Published 31 July 2014Last updated 30 May 2019 + show all updates
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Updated country TB guidance.
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First published.