Brunei Women Health Information
Reported, December 21, 2011
In Brunei Darussalam the lifetime average number of children per women is 2 compared with 2 in the UK.
No data are available on contraceptive use in this country.
49% of women aged 5069 years have undergone a breast examination or mammography compared to 75% in the UK and 72% of women aged 2069 years have undergone cervical cancer screening compared to 70% in the UK.
There is a moderate risk of anaemia in people from this country. Be alert to this possibility in recently arrived migrants, particularly for women and pre-school children, and test as clinically indicated.
Consider vitamin D deficiency in individuals who may be at risk as a result of their diet, skin colour or lack of sun exposure.
Anaemia
There is a moderate risk of anaemia in people from this country (estimated prevalence in non-pregnant women 20-40%). Be alert to this possibility in recently arrived migrants, particularly for women and pre-school children, and test as clinically indicated.
Vitamin D deficiency
Sunlight is the major source of vitamin D and dark skinned individuals or those who for cultural or religious reasons cover their whole bodies when outdoors are at risk of deficiency, as are those whose diets (vegetarian/vegan) do not contain an adequate vitamin D supply.
This country has a high prevalence of hepatitis B. Consider screening for hepatitis B, particularly among those who have recently arrived.
This country has a considerably higher prevalence of hepatitis C than the UK. Consider screening for hepatitis C.
There is a high risk of typhoid infection in this country.
TB
There is a high incidence of TB in this country (40 499 cases/100,000).
If known to be HIV positive refer to HIV team for further risk assessment and TB screening.
If not known to be HIV positive screen for TB and follow up according to NICE guidelines.
Offer chest X ray to all unless;
under 11 years of age
possibility of pregnancy
recent chest X ray
Offer Mantoux test if;
under 11 years of age
possibility of pregnancy
normal chest X ray but less than 36 years of age
Offer gamma interferon blood test if;
Mantoux test >6mm (no prior BCG)
Mantoux test >15mm (prior BCG)
Refer to TB services promptly if screening is positive.
Maintain long term vigilance for symptoms of TB even if initial screening is negative.
TB is a notifiable disease.
Please see TB page for further information.
HIV and sexually transmitted infections
No data are available on HIV prevalence in this country.
Please take other risk factors into consideration when assessing likely health needs in this area.
Hepatitis B
This country has a high prevalence of hepatitis B.
Consider screening for hepatitis B, particularly among those who have recently arrived.
All pregnant women should be offered screening for hepatitis B infection during each pregnancy.
Babies born to mothers who are hepatitis B positive should be appropriately immunised and followed-up accordingly.
The UK has a selective immunisation programme for hepatitis B; please see the Immunisation against Infectious Disease (Green Book) for further guidance.
Hepatitis C
This country has a considerably higher prevalence of hepatitis C than the UK.
Consider screening for hepatitis C.
Malaria
There is a very low risk of malaria in some areas of this country due to P. falciparum and P. vivax.
Information on which areas of this country are affected is available from NaTHNaC.
Any unwell patient with a history of arrival from or a visit to affected areas of this country in the last year must be tested for malaria.
Enteric fever
There is a high risk of typhoid infection in this country.
Ensure that travellers to this country are offered typhoid immunisation and advice on prevention of enteric fevers.