Paraguay: migrant health guide
Advice and guidance on the health needs of migrant patients from Paraguay 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
Screen all new entrants, including children, for tuberculosis (TB).
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. See Immunisation collection with complete schedules.
Tuberculosis
There is a high incidence of TB in Paraguay (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:
- screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
- test all sexually active patients under the age of 25 for chlamydia
Paraguay has a low rate of HIV (≤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
Hepatitis B
Paraguay 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
Paraguay has a higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C if other risk factors apply.
Typhoid
There is a risk of typhoid infection in Paraguay, so:
- ensure that travellers to Paraguay 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 Paraguay
Helminths
There is a risk of helminth infections in Paraguay, including soil transmitted helminthiasis.
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
Vitamin A
There may be a risk of vitamin A deficiency.
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Paraguay |
|---|---|---|
| Number of children per woman¹ | 1.7 | 2.4 |
| Use of contraception² | 71.7% | 68.4% |
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 Paraguay.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Paraguay.
Languages
| Language | Population (%) |
|---|---|
| Spanish (official) and Guarani (official) | 46.3 |
| Only Guarani | 34 |
| Only Spanish | 15.2 |
| Other¹ | 4.1 |
¹includes Portuguese, German, other Indigenous languages
Source: The World Factbook.
Religions
| Religion | Population (%) |
|---|---|
| Roman Catholic | 89.6 |
| Protestant | 6.2 |
| Other Christian | 1.1 |
| Other or unspecified | 1.9 |
| None | 1.1 |
Source: The World Factbook.
Migration to the UK
There were over 700 people from Paraguay living in England and Wales at the time of the 2011 Census.
Source: Office for National Statistics.
Updates to this page
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.