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Main messages

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 Eswatini (40 to 499 cases/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

There is a high rate of HIV in Eswatini (>1%), so:

• offer and recommend an HIV test to all adults according to
• consider offering an HIV test to infants and children who have recently arrived in the UK according to

Although recent global data on STIs are not available, countries with high HIV rates tend to have higher rates of STIs, and the range of STIs encountered in Swaziland may vary from those in the UK, so offer to sexually active individuals:

• a full sexual health screen
• safer sex health promotion advice by referral to local genito-urinary medicine services

Hepatitis B

Swaziland has a high 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

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

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 Eswatini, 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 Eswatini, so:

• ensure that travellers to Eswatini 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 Swaziland

Helminths

There is a risk of helminth infections in Eswatini, including:

• schistosomiasis
• soil transmitted helminthiasis

Women鈥檚 health

Reproductive health indicators

Reproductive health indicator	UK	Eswatini
Number of children per woman鹿	2	4
Use of contraception虏	82%	46%
Breast examination or mammography鲁	75%	5%
Cervical cancer screening鈦�	70%	4%

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 low risk of anaemia in adults (estimated prevalence is 5 to 20%) and a high risk in pre-school children (estimated prevalence is >40%), 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 high risk of vitamin A deficiency in Eswatini.

Country profile

Health indicators and health care

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

Culture, politics and history

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

Languages

The main languages used in Eswatini are:

• English (official, used for government business)
• siSwati (official)

Source:

Religions

Religion	Population (%)
窜颈辞苍颈蝉迟鹿	40
Roman Catholic	20
Muslim	10
翱迟丑别谤虏	30

鹿a blend of Christianity and indigenous ancestral worship; 虏includes Anglican, Baha鈥檌, Methodist, Mormon, Jewish

Source:

Migration to the UK

There were over 1,000 people from Eswatini living in England and Wales at the time of the 2011 Census.

Source: