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. 2025 Apr 11:15:04076.
doi: 10.7189/jogh.15.04076.

Estimating the economic burden of respiratory syncytial virus infection among children <2 years old receiving care in Maputo, Mozambique

Neele Rave  1 , Tufária Mussá  2 , An Nguyen  3 , Clint Pecenka  4 , Farina L Shaaban  1 , Louis J Bont  1 ; RSV GOLD III – Health Economics Study Group
Collaborators, Affiliations

Estimating the economic burden of respiratory syncytial virus infection among children <2 years old receiving care in Maputo, Mozambique

Neele Rave et al. J Glob Health. .

Abstract

Background: Data on costs of respiratory syncytial virus (RSV) in low- and lower-middle-income countries are urgently needed to inform the introduction of recently developed vaccines. We estimated the costs of lower respiratory tract infections associated with RSV infection in Mozambique.

Methods: We conducted a prospective cohort study to assess household and societal costs of RSV infection in children <2 years old who sought care in a referral hospital or a primary health centre in Mozambique during one local RSV season (February to August 2023). We used molecular point-of-care testing to confirm RSV status. We collected direct medical and non-medical costs and indirect cost data from hospital records and patient-level questionnaires at the initial visit and 2-4 weeks post-discharge.

Results: We recruited 544 children; 52.6% were girls and the median age was 9.3 months. From the sample, 286 children from the outpatient department, 233 from the paediatric wards, and 25 from the intensive care unit (ICU). RSV was confirmed in 42 (14.7%) outpatients, 111 (47.6%) inpatients, and 6 (24.0%) ICU cases. The mean total costs associated with RSV were USD 43 (95% confidence interval (CI) = 11-76) for outpatients, USD 612 (95% CI = 544-680) for inpatients, and USD 1161 (95% CI = 837-1485) for ICU cases. The government covered 16.9%, 89.9%, and 80.0% of overall societal costs for outpatients, inpatients, and ICU patients, respectively. The average household out-of-pocket costs for life-threatened RSV cases were more than 1.5 times the monthly minimum wage of USD 91, causing a high financial burden on families in Mozambique.

Conclusions: RSV infection represents a significant healthcare and economic burden in children <2 years old. Our results provide input for cost-effectiveness analyses and informed decision-making when considering RSV immunisation in Mozambique.

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Conflict of interest statement

Disclosure of interests: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose the following activities and/or relationships: LJB has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits. UMCU has received major funding (greater than EUR 100 000 per industrial partner) for investigator-initiated studies from AbbVie, MedImmune, Janssen Pharmaceuticals, the Bill & Melinda Gates Foundation, Nutricia (Danone), and MeMed Diagnostics. UMCU has received major cash or in-kind funding as part of the public-private partnership Innovative Medicines Initiative (IMI) – funded RESCEU (Respiratory Syncytial Virus Consortium in Europe) project from GlaxoSmithKline, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi. UMCU has received major funding by Julius Clinical for participating in the International Network For Optimal Resistance Monitoring of RSV study sponsored by MedImmune. UMCU has received minor funding for participation in trials by Regeneron Pharmaceuticals and Janssen from 2015 to 2017 (total annual estimate less than EUR 20 000). UMCU received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavarian Nordic, mAbxience, Novavax, Pfizer, and Janssen (total annual estimate less than EUR 20 000). LJB is the founding chair of the Respiratory Syncytial Virus Foundation (ReSViNET) Foundation. PATH receives funding from the Bill & Melinda Gates Foundation to support RSV-related work.

Figures

Figure 1
Figure 1
Flow diagram illustrating the total number of outpatients and inpatients included and excluded from the study. RSV – respiratory syncytial virus, SARI – severe acute respiratory infection. *Reasons for exclusion unknown, not included.
See this image and copyright information in PMC

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