Survival of Boda Boda Riders During COVID-19: Disease Risk in Kitende Parish, Uganda

Introduction: During Uganda’s COVID-19 lockdown, boda boda riders were the primary mode of transport, delivering goods, patients, and essential services. Despite daily exposure to potentially infected clients, no confirmed COVID-19 deaths were reported among riders in Kitende Parish, Kajjansi Municipality. This study explored their risk perception, practices, and health outcomes regarding communicable and non-communicable diseases post-pandemic. Methods: A mixed-methods study was conducted in Kitende Parish, covering 24 villages within a two-kilometer radius of Kajjansi Health Centre IV. Data were collected from 144 riders across 24 boda boda stages using questionnaires, focus group discussions, observations, and storytelling. Quantitative data were analyzed descriptively, and qualitative findings were thematically analyzed. Results: Of 144 riders, 60 (41%) used sanitizers early in the outbreak, while 84 (58%) improvised hand-washing containers to reassure customers. Mask use was inconsistent: 62 riders (43%) never wore masks but instructed customers to wear them, while 82 (56.9%) carried masks and wore them mainly when police were present. Most riders (74, 57%) supported 3–4 dependents, and 70 (48.6%) lived in single rented rooms. More than half (80, 55%) were unsure of their COVID-19 status, and all perceived it as “a disease of the rich.” Substance use was common, with 90 (62.5%) consuming alcohol or marijuana. Despite high exposure, no severe illness or deaths were reported among riders. Conclusion: The apparent survival of boda boda riders highlights potential surveillance gaps and exposure dynamics, yet their unsafe practices increase vulnerability to other diseases. Strengthen health education, PPE use, and routine health screening for boda boda riders to improve disease prevention and community health.