ArticleConflict and health2026
Longitudinal serological response to SARS-CoV-2 among Rohingya refugees in cox's bazar, Bangladesh: implications for pandemic preparedness in humanitarian settings.
Article in Conflict and health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRohingya Myanmar nationals are at high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to densely populated camp areas with inadequate water, sanitation, and hygiene (WASH) infrastructure, along with limited awareness of hygiene practices. This study aimed to characterize the longitudinal SARS-CoV-2 antibody dynamics among Rohingya refugees in Cox's Bazar to inform vaccination strategies and public health preparedness in humanitarian settings.
methodReverse transcription polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 positive cases and their household members were enrolled and followed at multiple time points to monitor the IgG antibody response against the SARS-CoV-2 receptor binding domain (RBD) of the spike (S) protein.
resultA total of 194 primary SARS-CoV-2 RT-PCR-positive cases were enrolled at baseline, of whom 47% were symptomatic, with the highest burden observed among individuals aged 18-55 years. At enrollment, 56% of primary cases had detectable IgG antibodies (≥ 500 ng/mL). Seropositivity increased to 80%, 88%, and 93% at days 30, 180, and 360, respectively. Among unvaccinated participants, RBD-specific IgG titers peaked at one month and remained detectable up to 12 months following natural infection. Among household members, seropositivity increased from 57% at enrollment to 71% at the one-month follow-up. Among vaccinated primary cases, antibody titers peaked at 1-2 months after vaccination and declined markedly within 4-5 months.
conclusionThis study demonstrates robust antibody responses following natural SARS-CoV-2 infection and a marked rise-but rapid decline-of vaccine-induced immunity among Rohingya refugees. The findings highlight the need for timely booster doses, strengthened vaccination coverage, and continued serological monitoring to maintain protective immunity in high-density humanitarian settings. These insights can support targeted public health interventions and pandemic preparedness strategies for displaced and vulnerable populations.
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