One in every five adult Rohingya refugees living in Cox’s Bazar is affected by Hepatitis C, according to research published in Asianews by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Operational data from the Refugee Relief and Repatriation Commissioner (RRRC) and Médecins Sans Frontières (MSF) echo this trend, revealing that viral hepatitis prevalence among the refugee population stands at 18.97 percent. In comparison, viral hepatitis affects just 2.01 percent of the surrounding Bangladeshi host population.
Hepatitis C Crisis Unfolds Among Rohingya Refugees in Cox’s Bazar
The stark disparity is driven overwhelmingly by Hepatitis C, which impacts 17.24 percent of refugees compared to only 1.01 percent of local residents. Furthermore, between 20 and 22 percent of the nearly 150,000 Rohingya who arrived in Bangladesh in recent months have tested positive for Hepatitis C, according to Sarwar Jahan, assistant medical coordinator at RRRC. These figures strongly suggest that the vast majority of infections originated in Myanmar rather than through widespread transmission within the camps.
Origins and Silent Symptoms of the Infection
Health officials and experts point to unsafe healthcare practices in Myanmar prior to displacement as the primary driver of the high infection rate. Documented risk factors include the reuse of unsterile syringes, unhygienic traditional medical procedures, unsafe birth care, and unscreened blood transfusions. Kamal Hossain, a 30-year-old refugee who fled Myanmar in 2017, recalled that medical workers sometimes used the same syringe for several patients without changing it
because nobody explained the risks at the time. His own diagnosis in 2025 explained years of unexplained exhaustion and sudden vision blackouts.
Because the disease often remains symptomless for years, many patients arrive without obvious warning signs, according to Sumaiya Yousuf, a medical doctor with the MSF Hepatitis C Project. When symptoms do appear, patients typically complain only of fatigue, poor appetite, or abdominal pain. Left untreated, Hepatitis C can silently progress to severe liver damage, liver cirrhosis, or liver cancer.
Treatment Gaps and Funding Shortages
While routine screening of pregnant women, safe blood transfusion practices, and targeted testing have helped significantly reduce new transmissions inside the camps, severe operational hurdles remain. Nearly 59,000 patients have been successfully enrolled in antiviral therapy. However, about 50,000 other diagnosed patients remain untreated due to critical funding shortages.
The public health challenge also extends beyond the refugee settlements. Hepatitis C prevalence among Bangladeshi residents living in the nearby sub-districts of Ukhiya and Teknaf has reached 2.3 percent, which is more than double the national average of approximately 1.1 percent.
Calls for Integration and Regional Strategy
Professor Dr Mohammad Ali, founder and secretary general of the National Liver Foundation of Bangladesh (NLFB), whose 2021 study first exposed the heavy hepatitis burden among refugees, emphasized the need for coordinated protection across both refugee and host communities. We need expanded screening, universal access to treatment, stronger infection prevention and sustained awareness programmes so that transmission can be interrupted before more people develop advanced liver disease,
Ali stated.
To address the crisis comprehensively, icddr,b researchers have recommended that Rohingya refugees be fully integrated into Bangladesh’s national viral hepatitis elimination strategy. Their core recommendations include:
- Culturally appropriate health education
- Wider access to rapid and confirmatory testing
- Free antiviral treatment for all active cases
- Routine hepatitis screening during pregnancy
- Timely Hepatitis B vaccination for newborns
