Sri Lanka: migrant health guide
Advice and guidance on the health needs of migrant patients from Sri Lanka 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 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, because Sri Lanka has an intermediate prevalence.
Consider screening for hepatitis C, because Sri Lanka has a considerably higher prevalence than the UK.
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.
Be advised that there is a high risk of typhoid infection in Sri Lanka.
Consider nutritional and metabolic concerns.
Find out more about children’s health.
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 in Sri Lanka (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
Sri Lanka 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
- be advised that national guidelines do not recommend routine consideration of HIV testing of infants and children who have recently arrived in the UK
Hepatitis B
Sri Lanka has an intermediate 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
Sri Lanka has a considerably higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C.
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 very low risk of malaria in Sri Lanka, so:
- test any unwell patient who has travelled to-and-from affected areas of Sri Lanka in the last year
- remember that malaria can be rapidly fatal
Typhoid
There is a high risk of typhoid infection in Sri Lanka, so:
- ensure that travellers to Sri Lanka 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 Sri Lanka
Women’s health
Reproductive health indicators
| Reproductive health indicator | UK | Sri Lanka |
|---|---|---|
| Children per woman¹ | 2 | 2 |
| Use of contraception² | 82% | 70% |
| Breast examination or mammography³ | 75% | 2% |
| Cervical cancer screening⁴ | 70% | 2% |
¹lifetime average ²by woman of reproductive age or partner ³women aged 50 to 69 years ⁴women aged 20 to 69 years
Female genital mutilation
Female genital mutilation (FGM) has occasionally been documented in Sri Lanka.
Find out more about women’s health.
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 in pre-school children (estimated prevalence is 20 to 40%), in Sri Lanka, 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 risk of vitamin A deficiency in Sri Lanka.
Country profile
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and healthcare in Sri Lanka.
Culture, politics and history
BBC News and The World Factbook provide background information on the culture, politics and history of Sri Lanka.
Languages
| Language | Population (%) |
|---|---|
| Sinhala¹ | 74 |
| Tamil² | 18 |
| Other | 8 |
¹official and national language ²national language
Source: The World Factbook.
Find out about language interpretation.
Religions
| Religion | Population (%)¹ |
|---|---|
| Buddhist² | 69.1 |
| Unspecified | 10 |
| Muslim | 7.6 |
| Hindu | 7.1 |
| Christian | 6.2 |
¹2001 Census provisional data ²official
Source: The World Factbook.
Migration to the UK
There were over 127,000 people from Sri Lanka living in England and Wales at the time of the 2011 Census.
Source: Office for National Statistics.
Updates to this page
Last updated 18 April 2016 + show all updates
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Updated advice on risks of malaria and helminths, based on current prevalence in Sri Lanka.
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First published.