Prevalence of COVID-19 Symptoms, Risk Factors, and Health Behaviors in Host and Refugee Communities in Cox’s Bazar: a Representative Panel Study

Prevalence of COVID-19 Symptoms, Risk Factors, and Health Behaviors in Host and Refugee Communities in Cox’s Bazar: a Representative Panel Study

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Paula López Peña, C. Austin Davis, Mushfiq Mobarak, Shabib Raihan


This project is studying the prevalence of COVID-19 symptoms in refugee and host communities and their correlates with current and pre-COVID-19 living conditions. Researchers administered a phone-based survey to a sample of 909 households in Cox's Bazar which was drawn from a household panel representative of Rohingya refugees and the host population. Researchers conducted a symptoms checklist to assess COVID-19 risk based on the WHO guidelines. The survey included questions covering returning migration, employment, and food security, and asked additional questions on health knowledge and behaviors to a random subsample (n=460). Results find that 24.6 percent of camp residents and 13.4 percent of those in host communities report at least one common symptom of COVID-19. Among those seeking treatment, a plurality did so at a pharmacy (42.3 percent in camps, 69.6 percent in host communities). While most respondents report good respiratory hygiene, between 76.7 percent (camps) and 52.2 percent (host community) had attended a communal prayer in the previous week. Another 47.4 percent (camps) and 34.4 percent (host community) had attended a non-religious social gathering. The presence of returning migrants, respondent mobility, and food insecurity strongly predict COVID-19 symptoms. The results suggest that COVID-19 symptoms are highly prevalent in Cox's Bazar, especially in refugee camps. Attendance at religious and social events threatens efforts to contain the spread of the disease. Pharmacies and religious leaders are promising outlets to disseminate life-saving information. 

Funding for this project was provided by the UK Department for International Development, awarded through IPA's Peace & Recovery Program.

Project Outcomes of Interest

COVID-19 symptoms, returning migration, employment, food security, health knowledge and behaviors


Yale MacMillan Center Program on Refugees, Gender and Adolescence: Global Evidence (GAGE), Yale Research Initiative on Innovation and Scale (Y-RISE), World Bank

Key Findings


  • Overall, COVID-19 symptoms were highly prevalent in Cox’s Bazar, particularly in refugee camps.
  • While most respondents reported good respiratory hygiene knowledge and practices, attendance at religious and social gatherings threatened to accelerate the spread of the disease.
  • The results suggest that social influence campaigns encouraging people to share information about COVID-19 and encourage others to adhere to public health recommendations may be needed.

Link to Results

Link to the working paper

Impact Goals

  • Improve social-safety net responses
  • Promote peace and safety, and improve humanitarian response
  • Reduce COVID-19 transmission rates

Project Data Collection Mode

  • CATI (Computer-assisted telephone interviewing)

Results Status