Costa Rica Women Health Information
Reported, January 2, 2012
In Costa Rica 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.
6% of women aged 5069 years have undergone a breast examination or mammography compared to 75% in the UK and 23% 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 may be a risk of vitamin A deficiency in this country.
Iodine deficiency
People from this country may be at risk of iodine induced hyperthyroidism due to excessive intake.
Patients should be offered an HIV test if they are newly registering in a high prevalence PCT or fall into a high risk group.
Take a sexual history and screen for STIs and HIV as appropriate.
This country has a low prevalence of hepatitis B. Ascertain any risk factors for HBV infection that may indicate the need for screening.
There is a risk of malaria in some areas of this country.
There is a risk of typhoid infection in this country.
There is a risk of chronic Chagas disease in migrants from this country. Primary care practitioners should be alert for possible cases and refer as appropriate.
TB
There is a low incidence of TB in this country (less than 40 cases/100,000).
Routine screening is not required but testing should be considered in patients who show signs and symptoms of TB.
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 (BHIVA guidelines).
In a high prevalence PCT (=2/1000) all newly registering patients should be offered an HIV test regardless of country of origin (BHIVA guidelines).
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 (see page 7 of BHIVA guidelines for list)
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 a low prevalance of hepatitis B.
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 the same or lower prevalence of hepatitis C than the UK.
Ascertain any risk factors for HCV infection that may indicate the need for screening.
Malaria
There is a risk of malaria in some areas of this country predominantly due to P. vivax.
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 risk of typhoid infection in this country.
Ensure that travellers to this country are offered typhoid immunisation and advice on prevention of enteric fevers.
Remember enteric fever in the differential diagnosis of illness in patients with a recent history of travel to or from this country.
Helminths
There is a risk of helminth infections including soil transmitted helminthiasis in this country.
Chagas disease
There is a risk of chronic Chagas disease in migrants from this country.
Primary care practitioners should be alert for possible cases and refer as appropriate.