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Bulgaria Women Health Information
– Reported, January 16, 2012
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
Anaemia
There is a low risk of anaemia in people from this country (estimated prevalence 5-20%). 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.
Vitamin A deficiency
There is a risk of vitamin A deficiency in this country.
TB
There is a high incidence of TB in this country (40 499 cases/100,000).
There is a high burden of Multi Drug Resistant (MDR) TB in this country.
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.
Local TB services should seek advice from the MDR-TB Clinical Advice Service before treating patients from this country for TB.
Maintain long term vigilance for symptoms of TB even if initial screening is negative.
TB is a notifiable disease.
HIV and sexually transmitted infections
This country has a low rate of HIV.
Test all sexually active patients under the age of 25 for chlamydia.
Take a sexual history and screen for STIs and HIV according to risk as specified in the UK national standards for the management of STIs (BASHH guidelines) and HIV .
In a high prevalence PCT (=2/1000) all newly registering patients should be offered an HIV test regardless of country of origin .
In a low prevalence PCT (less than 2/1000) patients in the following groups should be offered an HIV test:
pregnant women
patients presenting with an indicator disease or another STI
men disclosing sexual contact with other men
patients reporting a history of injecting drug use
patients reporting sexual contact with someone at increased risk of HIV infection
Hepatitis B
This country has an intermediate 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.
Hepatitis C
This country has a higher prevalence of hepatitis C.
Consider screening for hepatitis C if other risk factors apply.
Enteric fever
There is a risk of typhoid infection in this country.
– WF Team