Hantavirus seroprevalence and associated factors for exposure in south-central Uganda.

Orthohantaviruses are largely rodent-borne pathogens that can cause haemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome. In Uganda, the risk of human exposure is heightened by known rodent hosts, close human-rodent interaction in rural areas, and poor housing conditions. Despite this risk, data on human exposure remain scarce. This study sought to ascertain the seroprevalence of orthohantavirus exposure and identify associated factors with exposure among residents of the greater Masaka-Rakai region in Uganda. Seropositivity was assessed for orthohantavirus-specific IgG antibodies using commercial enzyme-linked immunosorbent assays. Logistic regression models were used to identify factors associated with seropositivity. Among 1,199 sera samples, orthohantavirus population-weighted seroprevalence was 7.4% (95% CI: 3.91-10.80). Males had a higher seroprevalence, while higher socioeconomic status was associated with a reduced burden of exposure to orthohantavirus. This study reports evidence of orthohantavirus exposure in Uganda, highlighting a previously underrecognized zoonotic risk in the region likely driven by close contact with rodent reservoirs and poor living conditions. The higher burden among males and lower-burden association with higher socioeconomic status, highlights the need for improved housing, rodent control, and integration of orthohantavirus surveillance into national public health programmes.