Respiratory syncytial virus (RSV) is a highly contagious, common respiratory virus that infects the lungs and airways in children. In South Africa, RSV is responsible for numerous hospitalizations and deaths in young children each year. In addition to the health burden, RSV-associated illness also has significant economic implications for households and the healthcare system. A study published in BMC Medicine sought to quantify the economic burden of RSV-associated illness in children under five years of age in South Africa from 2011 to 2016. The findings of this study may help inform policymakers and healthcare providers on the importance of preventative measures and treatment options for RSV.
Respiratory syncytial virus (RSV) is a common cause of respiratory infection in children, especially those under 5 years old, and can lead to hospitalization and even death. A study conducted in South Africa aimed to determine the cost burden of RSV-associated illness in children aged under 5 years.
The study enrolled 527 children with mild illness and 675 children with severe illness. The detection rate of RSV was 10% in those with mild illness and 26% in those with severe illness. Between 2-4% of children admitted with RSV-associated illness required intensive care admission and all of these were ventilated.
The mean annual household income for the study population was $559, with children enrolled in the cost study not differing from those not enrolled in terms of demographic and clinical features.
Healthcare system costs were highest for the youngest infants (aged 0-2 months) at $921.66 per episode, driven by a mean duration of hospitalization of 6.2 days in this age group, as compared to 4.7-5.6 days for older infants and children. Healthcare system costs for mild illness were more consistent, ranging from $24.98-$25.66 per episode across different age groups.
For children with severe illness, the cost to caregivers was highest in the 0-2 month age group at $77.55 out-of-pocket and indirect costs. Caregiver costs were similar across age groups for children with mild illness. The cost to caregivers for children admitted with severe illness was between 110-166% of the mean monthly household income.
The estimated mean annual cost of RSV-associated illness in children aged under 5 years was $137,204,393, with 76% ($111,742,713) being healthcare system incurred, 7% ($8,881,612) out-of-pocket expenses and 17% ($24,225,801) indirect costs. The total costs in dollars adjusted for the GDP deflator and the ZAR dollar exchange rate from 2014 to 2021 were $132,991,552.97.
The cost of RSV-associated severe illness was highest in the youngest infants (0-2 months), with 43% of healthcare system costs in this age group. The largest cost burden of mild illness was in the 12-59 month age group, with 89% of healthcare system costs in this age group. Non-medically attended illness costs were highest in the 1-4 year age group and accounted for 11% of the total costs of RSV-associated illness.
Overall, the study highlights the substantial economic burden associated with RSV-related illness in children, especially in the youngest and oldest age groups, and emphasizes the need for preventive measures such as RSV vaccination to reduce the associated costs and improve health outcomes.
In conclusion, the burden of RSV-associated illness in children aged <5 years in South Africa has significant economic implications that cannot be ignored. The data presented in this article highlights the need for effective prevention and management strategies to reduce the economic burden on families and the healthcare system. It is our hope that the findings in this article will inform policymakers and healthcare providers on the importance of investing in preventative measures such as vaccines and early diagnosis, which can ultimately reduce the economic burden of RSV in South Africa. We encourage further research in this area to better understand the full scope of the economic impact of RSV-associated illness, as well as innovative approaches to addressing this issue.
