Public health challenges posed by delays in obtaining COVID-19 clearance for long-distance truckers across East Africa

Spatial distribution of sexual network locations used by long-distance truck drivers along the Northern Corridor highway, Kenya

BACKGROUND

In Kenya, long-distance truck drivers (LDTDs) using the Northern Corridor highway have a high prevalence of HIV and other sexually transmitted infections (STIs) due to their risky sexual networks. However, the spatial distribution of the sexual network locations used by LDTDs is not well understood. Consequently, healthcare stakeholders have found it difficult to provide spatially targeted HIV/STI interventions among LDTDs. Thus, the study sought to establish the spatial distribution of sexual network locations used by LDTDs along the Northern Corridor highway, to inform efficient distribution and use of limited HIV/STI-prevention resources.

METHODS

A cross-sectional study design was used. The study adopted a systematic sampling technique. 296 LDTDs were interviewed using interviewer-administered questionnaires at the Mlolongo weighbridge in Kenya. The LDTDs listed their history of sexual interactions and highway stopovers used during the week preceding data collection. Geospatial modelling techniques, using R statistical software packages for spatial mapping, were employed. Shapefiles were created and overlaid over a map of Kenya using R statistical software to create maps of sexual networks.

RESULTS

Forty-two highway stopovers used by LDTDs were spatially distributed along the highway, from the Kenya coast to the Kenya-Uganda border. In general, LDTDs' sexual network hotspots were restricted to the outskirts of major cities along the Northern Corridor highway (Nairobi, Mombasa and Nakuru) as well as the Kenya-Uganda international border.

CONCLUSIONS

On the Northern Corridor highway, stopovers situated proximal to major urban areas, as well as those at international border points, frequently serve as sexual network hotspots among LDTDs and their sexual partners. Thus, healthcare stakeholders should improve access to HIV/STI-prevention services targeted for LDTDs at the sexual network hotspots identified in this study.

Containing the spatial spread of COVID-19 through the trucking network

The trucking industry is the backbone of domestic supply chains. In the context of the COVID-19 pandemic, road transportation has been essential to guarantee the supply of basic goods to confined urban areas. However, the connectivity of the trucking network can also act as an efficient virus spreader. This paper applies network science to uncover the characteristics of the trucking network in one major Latin American country -Colombia- and provides evidence on freight networks' ability to spread contagious diseases spatially. Network metrics, official COVID-19 records at the municipality level, and a zero-inflated negative binomial model are used to test the association between network topology and confirmed COVID-19 cases. Results suggest that: (i) the number of COVID-19 cases in a municipality is linked to its level and type of network centrality; and (ii) being a port-city and a primary economic hub in the trucking network is associated with a higher probability of contracting earlier a pandemic. Based on these results, a risk-based approach is proposed to help policymakers implement containment measures.