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Main messages

Infectious diseases

Immunisation

Ensure that all patients, especially children, are up-to-date with the UK immunisation schedule.

Tuberculosis (TB)

There is a low incidence of TB in Guatemala (<40 cases per 100,000), so:

• routine screening is not required
• consider testing for TB (including children) if the patient shows 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

Guatemala 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
• 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

Guatemala 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

Guatemala has a higher prevalence of hepatitis C than the UK, so .

Travel plans and advice

Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin, and see , or the Health Protection Scotland websites ( and ), for travel advice.

Malaria

There is a low risk of malaria in some areas of Guatemala, 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 risk of typhoid infection in Guatemala, so:

• ensure that travellers to Guatemala 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 Guatemala

Helminths

There is a risk of helminth infections in Guatemala, including soil transmitted helminthiasis.

Chagas disease

There is a risk of chronic Chagas disease in migrants from Guatemala, so:

• be alert for possible cases
• refer as appropriate

Women鈥檚 health

Reproductive health indicators

Reproductive health indicator	UK	Guatemala
Children per woman鹿	2	4
Use of contraception虏	82%	43.3%
Breast examination or mammography鲁	75%	14%
Cervical cancer screening鈦�	70%	40%

鹿lifetime average 虏by woman of reproductive age or partner 鲁women aged 50 to 69 years 鈦磜omen aged 20 to 69 years

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 high risk in pre-school children (estimated prevalence is >40%), in Guatemala, 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 Guatemala.

Iodine

People from Guatemala may be at risk of iodine induced hyperthyroidism due to excessive intake.

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

Language	Population (%)
Spanish	60
Amerindian languages鹿	40

鹿there are 23 officially recognized Amerindian languages, including:

• Quiche
• Cakchiquel
• Kekchi
• Mam
• Garifuna
• Xinca

Source: .

Religions

The main religions in Guatemala are:

• Roman Catholic
• Protestant
• indigenous Mayan beliefs

Source: .

Migration to the UK

There were over 800 people from Guatemala living in England and Wales at the time of the 2011 Census.

Source: 漏 Crown Copyright 2014.