Laos Women Health information
Reported, December 24, 2011
In Lao People’s Democratic Republic the lifetime average number of children per women is 3 compared with 2 in the UK.
32.2% of women of reproductive age report using (or a partner using) a contraceptive method compared with 82% in the UK.
2% of women aged 5069 years have undergone a breast examination or mammography compared to 75% in the UK and 3% of women aged 2069 years have undergone cervical cancer screening compared to 70% in the UK.
There is a high 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.
There is a high risk of vitamin A deficiency in this country.
Anaemia
There is a high risk of anaemia in people from this country (estimated prevalence in non-pregnant women >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.
Vitamin A deficiency
There is a high risk of vitamin A deficiency in this country.
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 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 malaria in some areas of this country.
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.
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 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.
Hepatitis C
This country has a considerably higher prevalence of hepatitis C than the UK.
Consider screening for hepatitis C.
Malaria
There is a high risk of malaria in some areas of this country predominantly due to P. falciparum.
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.
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 schistosomiasis, lymphatic filariasis and soil transmitted helminthiasis in this country.
