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

Abstract

Background The hepatitis C virus (HCV)—a communicable disease of global health concerns—affects approximately 20% of the Rohingya refugee population in Cox’s Bazar, Bangladesh, which is higher than that observed in its endemic country and the host population. This study will assess socio-demographic, medical, traditional and behavioural factors contributing to HCV risk among the Rohingya refugee population to provide the basis for future prevention efforts. Methods A mixed-method study using a sequential explanatory design, combining 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=50) with caregivers, healthcare providers and community members will help explain and expand on the 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 behaviours and sexual practices, and assess their association with HCV seropositivity. Findings will support recommendations for evidence-based prevention as well as policy and community initiatives to reduce HCV transmission among refugee populations. Ethics and dissemination Ethical approval has been obtained from Cox’s Bazar Medical College Hospital (Approval Ref: CoXMC/2024/019). Findings will be disseminated through peer-reviewed publications and stakeholder workshops to inform policy and programmes.