Rave Neele, Mussá Tufária, Nguyen An, Pecenka Clint, Shaaban Farina L, Bont Louis J
Department of Paediatrics, University Medical Centre Utrecht, Utrecht, The Netherlands.
Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique.
J Glob Health. 2025 Apr 11;15:04076. doi: 10.7189/jogh.15.04076.
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.
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.
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.
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.
迫切需要低收入和中低收入国家呼吸道合胞病毒（RSV）成本的数据，以为引进最近研发的疫苗提供参考。我们估计了莫桑比克与RSV感染相关的下呼吸道感染成本。
我们进行了一项前瞻性队列研究，以评估在一个当地RSV流行季节（2023年2月至8月）期间，在莫桑比克一家转诊医院或初级卫生中心就诊的2岁以下儿童RSV感染的家庭和社会成本。我们使用分子即时检测来确认RSV状态。我们在初次就诊时以及出院后2至4周，从医院记录和患者层面问卷中收集直接医疗和非医疗成本以及间接成本数据。
我们招募了544名儿童；52.6%为女孩，中位年龄为9.3个月。样本中，286名儿童来自门诊部，233名来自儿科病房，25名来自重症监护病房（ICU）。门诊患者中42例（14.7%）、住院患者中111例（47.6%）以及ICU病例中6例（24.0%）确诊为RSV感染。RSV感染门诊患者的平均总成本为43美元（95%置信区间（CI）=11 - 76），住院患者为612美元（95%CI = 544 - 680），ICU病例为1161美元（95%CI = 837 - 1485）。政府分别承担了门诊患者、住院患者和ICU患者总体社会成本的16.9%、89.9%和80.0%。危及生命的RSV病例家庭平均自付费用超过每月91美元最低工资的1.5倍，给莫桑比克家庭带来了沉重的经济负担。
RSV感染给2岁以下儿童带来了巨大的医疗和经济负担。我们的结果为成本效益分析以及莫桑比克在考虑RSV免疫接种时的明智决策提供了依据。
