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A new study shows a significant difference in RSV-related mortality between high- and low-income population groups, which is primarily due to prevalent health disparities globally.

Respiratory syncytial virus (RSV) is among the most significant causes of acute lower respiratory tract infection (ALRI) in children below the age of 5 years. This results not only in significant childhood mortality but also a greater risk of subsequent development of ailments like asthma. Despite RSV being a significant health threat to children, its global disease burden is poorly understood. This could be due to multiple factors, including poor access to widespread testing in economically deprived parts of the world.

A systematic review and meta-analysis published in April 2023 in the journal Influenza and Other Respiratory Viruses explored the global burden of RSV, with the secondary aim of identifying the factors that predispose specific population groups to RSV. The review analyzed 44 studies and found RSV-related global childhood mortality (in those below 5 years of age) at 0.5 per 100 children per year (in-hospital mortality) and 0.05 per 100 children per year (overall mortality rates). Results indicate that socioeconomic disparities significantly influence childhood mortality related to the infection.

Sub-Group Analysis Sheds Light on Significant Global Disparities

Though the primary aim of the study was to find in-hospital and overall childhood mortality due to RSV, it also analyzed the differences in various population groups and identified that socioeconomic disparities significantly contribute to RSV-related mortality. Thus, the study found that in-hospital RSV-related mortality in high-income nations was 0.1–0.2 per 100 children per year, whereas in low- and middle-income nations combined, it was 1.8 per 100 children per year. Similarly, RSV-related overall mortality in high-income nations was 0.02 vs. 0.9 per 100 children per year in low- and middle-income nations.

The Bottom line

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This study shows that socioeconomic factors are among the significant contributors to RSV-related mortality. Thus, economically deprived groups are at statistically significant risk. The risk of RSV-related in-hospital mortality in economically deprived population groups is almost nine times higher, and the overall mortality risk is more than four times higher than that in economically advantaged groups. This study also highlights the importance of understanding RSV-related mortality among various population groups in any given nation. The authors recommend active community surveillance as a top priority.


Duan, Y., Jiang, M., Huang, Q., Jia, M., Yang, W., & Feng, L. (2023). Incidence, hospitalization, and mortality in children aged 5 years and younger with respiratory syncytial virus‐related diseases: A systematic review and meta‐analysis. Influenza and Other Respiratory Viruses, 17(5). https://doi.org/10.1111/irv.13145