188体育

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鈥檝e 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).

Consider screening for hepatitis B, particularly among those who have recently arrived. Brunei Darussalam has an intermediate prevalence.

There is a high risk of typhoid infection in Brunei Darussalam.

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 Brunei Darussalam (40 to 499 cases per 100,000), so:

• screen all new entrants (including children) for TB according to
• 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 other risk factors into consideration when assessing likely health needs relating to HIV and STIs (no data are available on HIV prevalence in Brunei Darussalam).

Hepatitis B

Brunei Darussalam 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聽and a selective immunisation programme for higher risk groups

Hepatitis C

The prevalence of hepatitis C is higher than the UK, so if other risk factors apply.

Malaria

There is a very low risk of malaria in Brunei Darussalam, due to P. falciparum and P. vivax, so:

• who has travelled to and from in the last year
• remember that malaria can be rapidly fatal

Typhoid

There is a high risk of typhoid infection in Brunei Darussalam, so:

• ensure that travellers to Brunei Darussalam 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 Brunei Darussalam

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 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 a mild risk in pre-school children (estimated prevalence 5 to 20%), 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鈥檚 health

Reproductive health indicators

Reproductive health indicator	UK	Brunei Darussalam
Number of children per woman鹿	1.7	1.8

鹿lifetime average

No data are available on:

• contraceptive use
• mammography screening rates
• cervical cancer screening rates

Country profile

Health indicators and health care

has a summary of health indicators and health care in Brunei Darussalam.

Culture, politics and history

and provide background information on the culture, politics and history of Brunei Darussalam.

Languages

The main languages used in Brunei Darussalam are:

• Malay (Bahasa Melayu)鹿
• English
• Chinese dialects

鹿辞蹿蹿颈肠颈补濒

Source: .

Religions

Religion	Population (%)
惭耻蝉濒颈尘鹿	78.8
Christian	8.7
Buddhist	7.8
翱迟丑别谤虏	4.7

鹿辞蹿蹿颈肠颈补濒; 虏includes indigenous beliefs

Source:

Migration to the UK

There were almost 5,000 people from Brunei Darussalam living in England and Wales at the time of the 2011 Census.