Panama: migrant health guide
Advice and guidance on the health needs of migrant patients from Panama for healthcare practitioners.
Main messages
If the patient is new to the UK:
- explain to them how the NHS works and their entitlements to healthcare
- discuss how this compares to the healthcare system they’ve been used to
- follow guidance on how to comprehensively assess new migrant patients
- ensure that they are up-to-date with the UK immunisation schedule
- ask about any travel plans the patient may have to visit friends and relatives in their country of origin
Offer and recommend an HIV test to all adults, 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
Due to a low prevalence, ascertain any risk factors for hepatitis B infection that may indicate the need for screening.
The prevalence of HTLV is high.
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. See Immunisation collection with complete schedules.
Tuberculosis
There is a low incidence of TB in Panama (<40 cases/100,000), so:
- routine screening for TB is not required
- consider testing in patients (including children) who show signs and symptoms
- be aware that TB is a notifiable disease
Sexually transmitted infections and HIV
There is a high rate of HIV in Panama (>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 Panama 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
Panama has 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 universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
Hepatitis C
Panama has the same or lower prevalence of hepatitis C than the UK, so ascertain any risk factors for HCV infection that may indicate the need for screening
Malaria
There is a risk of malaria in Panama, mainly due to P. vivax, so:
- test any unwell patient who has travelled to or from affected areas of Panama in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a risk of typhoid infection in Panama, so:
- ensure that travellers to Panama 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 Panama
Helminths
There is a risk of soil transmitted helminth infections.
Chagas
There is a risk of chronic Chagas disease in migrants, 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.
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:
- darker skin
- those who are not often outdoors
- those who cover up most of their skin when outdoors
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Panama |
|---|---|---|
| Number of children per woman¹ | 1.7 | 2.4 |
| Use of contraception² | 71.7% | 50.8% |
¹lifetime average; ²by woman of reproductive age or partner
Country profile
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Panama.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Panama.
Languages
Many Panamanians are bilingual. The main languages used in Panama are:
- Spanish (official)
- Indigenous languages (including Ngabere (or Guaymi), Buglere, Kuna, Embera, Wounaan, Naso (or Teribe), and Bri Bri)
- Panamanian English Creole (similar to Jamaican English Creole; a mixture of English and Spanish with elements of Ngabere; also known as Guari Guari and Colon Creole)
- English
- Chinese (Yue and Hakka)
- Arabic
- French Creole
- Yiddish
- Hebrew
- Korean
- Japanese
Source: The World Factbook.
Religions
| Religion | Population (%) |
|---|---|
| Roman Catholic | 48.6 |
| Evangelical | 30.2 |
| Other | 4.7 |
| Agnostic | 0.2 |
| Atheist | 0.2 |
| None | 12.3 |
| Unspecified | 3.7 |
Source: The World Factbook.
Migration to the UK
There were over 600 people from Panama living in England and Wales at the time of the 2011 Census.
Source: Office for National Statistics.
Last updated 22 September 2021 + show all updates
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Updated country guidance on prevalence of communicable diseases and other health topics.
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First published.