Muwonge Adrian, Bessell Paul R, de Clare Bronsvoort Mark Barend, Mugerwa Ibrahim, Mwaka Erisa, Ssebaggala Emmanuel, Wee Bryan Aidan, Kiayias Aggelos, Mpyangu Christine Mbabazi, Joloba Moses Lutakome
Digital One Health Laboratory, The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
Division of Epidemiology, The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
J Epidemiol Glob Health. 2025 Apr 3;15(1):54. doi: 10.1007/s44197-025-00387-w.
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.
Using 625,422 national surveillance records, we fitted a susceptible-infectious-recovered 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.
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.
货运卡车司机连接着偏远社区，带来了潜在的疾病引入风险。然而，干预措施必须在公共卫生保护、经济连续性和个人权利之间取得平衡。本研究考察了在新冠疫情德尔塔毒株流行期间，货运在乌干达疾病引入和传播中的作用。
利用625422份国家监测记录，我们拟合了一个易感-感染-康复模型，以评估货运司机是否为“核心风险群体”。尽管他们仅占新冠病例的0.036%，但与货运相关的边境地区的病例数比内陆地区多12.02%，这表明货运在疾病引入中发挥了作用。风险因地点而异，托罗罗的负担比分别与南苏丹和坦桑尼亚接壤的阿穆鲁和基奥泰拉高。在马拉巴边境口岸进行强制性新冠病毒检测和等待检测结果，使托罗罗的疾病风险增加了6%。虽然针对货运的干预措施减少了边境地区的病例，但对内陆地区的影响微乎其微，这表明货运在疾病传播中的作用有限。我们的研究结果还表明，将针对货运的措施与疫苗接种相结合将进一步减少病例数。
我们的研究结果表明，卡车司机是一个短暂的核心风险群体，对疾病传播的影响有限。然而，他们作用的程度仍存在不确定性，在边境口岸进行检测和等待检测结果等干预措施可能无意中增加了风险。大流行防范策略应仔细评估供应链等关键部门的风险，以平衡公共安全和个人权利。
