Protocol for a Comprehensive Analysis of Hepatitis C Risk Factors among the Rohingya Population in Camp Settings in Cox’s Bazar: A Mixed-Method Study
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Background
The hepatitis C virus (HCV)—a communicable disease with global health concerns—affects approximately 20% of the Rohingya refugee population in Cox’s Bazar, Bangladesh, which is higher than in its endemic countries and host population. While researchers have yet to determine specific transmission risk factors for this vulnerable, underserved, and overlooked cohort, the HCV seroprevalence is significantly high. Thus, this study will assess socio-demographic, medical, traditional, and behavioral factors contributing to HCV risk among the Rohingya refugee population to provide the basis for future prevention efforts.
Methods
A mixed-method study comprised of both qualitative and quantitative approaches will be employed. For phase one, a case-control study of 900 HCV positive cases and 900 matched HCV negative controls will be conducted to determine associations with risk factors through semi-structured questionnaires. For phase two, focus group discussions (n=12) and key informant interviews (n=30) with caregivers, healthcare providers, and community members will help explain and expand on quantitative findings. Analyses will include logistic regression (quantitative) and thematic analysis (qualitative).
Expected Outcomes
The study aims to identify key risk factors including unsafe medical practices, traditional procedures, personal hygiene behaviors, and sexual practices—and assess their association with HCV seropositivity. Findings will support recommendations for evidence-based prevention and policy and community initiatives to reduce HCV transmission among refugee populations.
Ethics & Dissemination
Ethics approval was obtained from Cox’s Bazar Medical College Hospital. Study findings will be disseminated via publication in a peer-reviewed journal and workshops with stakeholders to guide public health response.
Author summary
Hepatitis C is an overlooked public health issue in the refugee setting. We intend to determine the risk factors for the elevated rates of Hepatitis C among the Rohingya refugees living in the camps of Cox’s Bazar in Bangladesh. Using a mixed-method approach, we will use quantitative epidemiological analysis of medical information and risk behavior collected from 1,800 refugees and qualitative information collected from focus groups with (medical) community stakeholders. The expected results will allow for implementation of a culturally specific motivation for prevention and evidence-based policy for reduced Hepatitis C transmission in refugee settings. A transdisciplinary project with researchers/academics from IOM, Save the Children, WHO and local/international NGOs.
