188体育

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 high incidence of TB in Nicaragua (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 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

Nicaragua 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

Nicaragua 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

Nicaragua 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 Nicaragua, 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 Nicaragua, so:

• ensure that travellers to Nicaragua 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 Nicaragua

Helminths

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

Chagas disease

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

• be alert for possible cases
• refer as appropriate

Women鈥檚 health

Reproductive health indicators

Reproductive health indicator	UK	Nicaragua
Children per woman鹿	2	3
Use of contraception虏	82%	68.6%

鹿lifetime average 虏by woman of reproductive age or partner

No data are available on:

• mammography screening rates
• cervical cancer screening rates

Nutritional and metabolic concerns

Anaemia

There is a low risk of anaemia in adults (estimated prevalence in non-pregnant women is 5 to 20%), and in pre-school children (estimated prevalence is 5 to 20%), in Nicaragua, so:

• be alert to this possibility in recently arrived migrants, particularly for 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 Nicaragua.

Iodine

People from Nicaragua 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 Nicaragua.

Culture, politics and history

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

Languages

Language	Population (%)
厂辫补苍颈蝉丑鹿	95.3
Miskito	2.2
惭别蝉迟颈锄辞虏	2
Other	0.5

鹿official 虏of the Caribbean coast

Source: .

Religions

Religion	Population (%)鹿
Roman Catholic	58.5
笔谤辞迟别蝉迟补苍迟虏	23.2
None	15.7
Other	1.6
Jehovah鈥檚 Witness	0.9

鹿2005 est. 虏Evangelical 21.6%, Moravian 1.6%

Source: .

Migration to the UK

There were over 300 people from Nicaragua living in England and Wales at the time of the 2011 Census.

Source: 漏 Crown Copyright 2014