One in every five adult Rohingya refugees living in Bangladesh’s Cox’s Bazar camps has Hepatitis C, according to new medical research and humanitarian health data, raising concerns over a hidden public health crisis as nearly 50,000 infected refugees remain without treatment due to funding shortages.

The findings were highlighted in a study conducted by icddr,b, published in BMC Public Health in May, alongside operational data from the Refugee Relief and Repatriation Commissioner (RRRC) and Médecins Sans Frontières (MSF).

Hepatitis C Rate Far Higher Than Host Community

The icddr,b study found that 18.97 percent of Rohingya refugees were infected with viral hepatitis, compared with 2.01 percent among nearby Bangladeshi host communities.

The disparity was largely driven by Hepatitis C, which affected 17.24 percent of Rohingya refugees, compared with just 1.01 percent of local residents.

The study, titled “Prevalence and Risk Factors of Hepatitis B and C Virus Infections among Rohingya Refugees and Host Communities in Teknaf, Cox’s Bazar, Bangladesh,” identified a significantly higher disease burden among displaced Rohingyas.

New Arrivals Also Showing High Infection Rates

According to Sarwar Jahan, Assistant Medical Coordinator at the RRRC, between 20 and 22 percent of the nearly 150,000 Rohingyas who recently entered Bangladesh tested positive for Hepatitis C.

The figures indicate that most infections were likely acquired in Myanmar before displacement rather than through widespread transmission inside refugee camps.

Years Without Symptoms

For many refugees, the disease remains undetected for years.

Thirty-year-old Kamal Hossain, who fled Myanmar in 2017, said he was diagnosed with Hepatitis C only in 2025 after suffering years of unexplained fatigue and temporary vision loss.

Medical staff say Hepatitis C often progresses silently.

Patients frequently report only fatigue, poor appetite or abdominal pain, while many experience no noticeable symptoms until serious liver damage develops, according to Sumaiya Yousuf, a physician with the MSF Hepatitis C Project.

Looking back, Kamal believes unsafe medical practices in Myanmar contributed to his infection.

“Doctors sometimes used the same syringe for several patients without changing it. At the time, we thought that was normal because nobody explained the risks,” he said.

Kamal has since completed antiviral treatment and recovered. His parents and sister were also diagnosed with the virus.

Thousands Still Waiting for Treatment

RRRC data show that nearly 59,000 patients have received antiviral treatment.

However, around 50,000 infected refugees remain untreated because of limited funding.

Medical experts warn that untreated Hepatitis C can eventually lead to liver cirrhosis and liver cancer.

Longstanding Concerns Over Unsafe Medical Practices

The issue was first brought to national attention by Professor Dr. Mohammad Ali, Founder and Secretary General of the National Liver Foundation of Bangladesh (NLFB).

His pioneering 2021 study identified widespread risk factors inside Myanmar, including:

  • Reuse of unsterilized syringes
  • Unsafe traditional medical procedures
  • Poor hygiene during childbirth
  • Unscreened blood transfusions

He stressed that protecting both refugee and host communities requires coordinated public health measures.

Need for Expanded Screening and Treatment

Hepatitis C prevalence among Bangladeshis living in Ukhiya and Teknaf has reached 2.3 percent, more than double the national average of around 1.1 percent, underscoring the need for continued surveillance.

According to RRRC, routine screening of pregnant women, improved blood safety and targeted testing have significantly reduced new infections inside the refugee camps.

“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,” Professor Ali said.

The icddr,b researchers also recommended integrating Rohingya refugees into Bangladesh’s national viral hepatitis elimination strategy.

Their recommendations include:

  • Expanded community health education
  • Greater access to rapid and confirmatory testing
  • Free antiviral treatment for all active cases
  • Routine hepatitis screening during pregnancy
  • Timely Hepatitis B vaccination for newborns

 

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