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 Peru (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

Peru 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

Peru 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

Peru has 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 high risk of malaria in some areas of Peru, 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 Peru, so:

• ensure that travellers to Peru 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 Peru

Helminths

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

Chagas disease

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

• be alert for possible cases
• refer as appropriate

Women鈥檚 health

Reproductive health indicators

Reproductive health indicator	UK	Peru
Children per woman鹿	2	3
Use of contraception虏	82%	71.3%

鹿lifetime average 虏by woman of reproductive age or partner

No data are available on:

• mammography screening rates
• cervical cancer screening rates

Female genital mutilation

Female genital mutilation(FGM) has occasionally been documented in Peru.

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 a moderate risk in pre-school children (estimated prevalence is 20 to 40%), in Peru, 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 Peru.

Iodine

People from Peru 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 Peru.

Culture, politics and history

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

Languages

Language	Population (%)鹿
厂辫补苍颈蝉丑虏	84.1
蚕耻别肠丑耻补虏	13
础测尘补谤补虏	1.7
Other native languages	0.7
Ashaninka	0.3
翱迟丑别谤鲁	0.2

鹿2007 est. 虏official 鲁includes foreign languages and sign language

Source: .

Religions

Religion	Population (%)鹿
Roman Catholic	81.3
Evangelical	12.5
Other	3.3
None	2.9

鹿2007 est.

Source: .

Migration to the UK

There were almost 7,000 people from Peru living in England and Wales at the time of the 2011 Census.

Source: 漏 Crown Copyright 2014.