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

Ascertain any risk factors for hepatitis B infection that may indicate the need for screening, because Cuba has a low prevalence.

There is a risk of typhoid infection in Cuba.

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 Cuba (<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

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

Cuba has a low rate of HIV (鈮�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

Cuba 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聽and a selective immunisation programme for higher risk groups

Hepatitis C

Cuba has a higher prevalence of hepatitis C than the UK, so if other risk factors apply.

Typhoid

There is a risk of typhoid infection in Cuba, so:

• ensure that travellers to Cuba 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 Cuba

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 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 may be a risk of vitamin A deficiency in Cuba.

Women鈥檚 health

Reproductive health indicators

Reproductive health indicator	UK	Cuba
Number of children per woman鹿	1.7	1.6
Use of contraception虏	71.7%	73.7%

鹿lifetime average; 虏by woman of reproductive age or partner

No data are available on:

• mammography screening rates
• cervical cancer screening rates

Country profile

Health indicators and health care

has a summary of health indicators and health care in Cuba.

Culture, politics and history

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

Languages

The main language used in Cuba is Spanish.

Source:

Religions

The main religions in Cuba are:

Religion	Population (%)
Christian	58.9
Folk religion	17.6
叠耻诲诲丑颈蝉迟鹿	1
贬颈苍诲耻鹿	1
闯别飞颈蝉丑鹿	1
惭耻蝉濒颈尘鹿	1
翱迟丑别谤鹿	1
None	23.2

鹿 <1%

Source:

Migration to the UK

There were almost 2,000 people from Cuba living in England and Wales at the time of the 2011 Census.

Source: