Portuguese expatriates' health in Angola and Mozambique-a cross-sectional study: increasing awareness and need for more surveillance.

Background: Increasing numbers of expatriates are working in sub-Saharan Africa. There is little published data on the complex population and this survey aimed at understanding expatriate morbidity by accessing self-reported health problems and malaria preventive practices.
Methods: A cross-sectional web-based survey was conducted targeting Portuguese expatriates in Angola and Mozambique. Logistic regression analysis explored factors associated with self-reported health problems and psychological symptoms in the previous 3 months.
Results: A total sample of 352 adult Portuguese urban civil occupational expatriates was obtained. Median length of expatriation was 3 years. Considering a 3-month timeframe, one in five expatriates reported new health problems and need of medical assistance, 5% were hospitalized and 64% reported general psychological symptoms. Less than 2% of subjects were on malaria chemoprophylaxis. Having chronic health conditions doubled the reporting of new health problems. Increasing length of expatriation was associated with decreasing reporting of general psychological symptoms. Directors and executive managers and expatriates living alone tended to report more general psychological symptoms.
Conclusion: Expatriate communities deserve enhanced surveillance for the health issues that affect them. This will improve evidence-based preparation and intervention by public and travel health practitioners.
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