Abstract

Background: Haulage truck drivers connect distant communities, posing potential disease introduction risks. However, interventions must balance public health protection, economic continuity, and individual rights. This study examines the role of haulage in disease introduction and onward spread in Uganda during the Delta wave of COVID-19.

Methods: Using 625,422 national surveillance records, we fitted a susceptible-infectious-recovered (SIR) model to assess whether haulage drivers were a “core-risk group.” Although they accounted for only 0.036% of COVID-19 cases, border districts associated with haulage registered 12.02% more cases than inland districts, suggesting a role in disease introduction. The risk varied by location, with Tororo experiencing a higher burden than Amuru and Kyotera, which border South Sudan and Tanzania, respectively.

Mandatory COVID-19 testing and result waiting at the Malaba border crossing increased disease risk in Tororo by up to 6%. While haulage-targeted interventions reduced cases in border districts, they had minimal impact on inland districts, indicating a limited role in onward spread. Our findings also suggest that integrating haulage-specific measures with vaccination would further reduce case-load.

Conclusions: Our findings suggest that truck drivers were a transient core risk group with limited impact on onward spread. However, uncertainties remain regarding the extent of their role, and interventions like testing and result waiting at border crossings may have inadvertently heightened risk. Pandemic preparedness strategies should carefully assess risks in key sectors like supply chains to balance public safety with individual rights.

Rights

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Cite as

Muwonge, A., Bessell, P., Bronsvoort, M., Mugerwa, I., Mwaka, E., Ssebaggala, E., Wee, B., Kiayias, A., Mpyangu, C. & Joloba, M. 2025, 'Assessing the Impact of Haulage drivers in Uganda's COVID-19 Delta Wave', Journal of Epidemiology and Global Health, 15, article no: 54. https://doi.org/10.1007/s44197-025-00387-w

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Last updated: 01 May 2025
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