Telford, C.; Nyakarahuka, L.; Baluku, J.; Mutesi, J.; Song, C.; Boyce, R.; Emch, M.; Edwards, J.; Shoemaker, T.; Lessler, J.

Rift Valley fever (RVF) is a mosquito-borne disease that can cause severe illness and death in both humans and livestock. Since 2016, Uganda has experienced recurrent but localized RVF outbreaks concentrated in the countrys southwestern region. The ecological drivers of this emergence remain unclear, as outbreaks have occurred throughout the year and show little association with meteorological patterns. We evaluated whether crop cultivation, particularly banana cultivation, is associated with RVF outbreak occurrence after controlling for likely confounders. We conducted a longitudinal study of human-inhabited 5 x 5 km grid cells across southwestern Uganda from 2016-2024. Annual Sentinel-2 satellite imagery composites were used to classify land cover into banana, coffee, ground crops, and non-crop categories, and the proportion of each land type was calculated for every grid-cell year. Because land cover proportions are compositional, isometric log-ratio transformations were used to estimate the independent effects of each land type. Confounding was addressed through propensity weighting, and crop substitution effects were estimated using g-computation. Banana land cover was the only land type consistently associated with increased RVF outbreak likelihood. In grid-cell years with low baseline banana cover, a 10-percentage point substitution from other land classes into banana was associated with a 1.64-fold increase in the odds of an RVF outbreak (95% CI: 1.17-2.29). In a simplified banana-only model, each 10-percentage point increase in banana cover was associated with a 1.21-fold increase in outbreak odds (95% CI: 1.02-1.43). Holding banana cover constant, substitutions among coffee, ground crop, and non-crop land showed weak or null associations. These findings suggest that banana cultivation may be an important ecological feature influencing RVF transmission dynamics and outbreak risk in southwestern Uganda.