Estimating the economic burden of RSV infection among children in North-West Nigeria

A new prospective cost-of-illness study in the Journal of Global Health quantifies the economic burden of respiratory syncytial virus (RSV) among children under 2 years old seeking care in North-West Nigeria—evidence that is increasingly important as new RSV prevention tools (maternal vaccination and long-acting monoclonal antibodies such as nirsevimab) enter policy discussions. The research team followed children presenting with acute respiratory infection during one RSV season (April–November 2023), enrolling outpatients (non-severe), inpatients (severe), and intensive-care/fatal cases (life-threatening), and capturing direct medical, direct non-medical, and indirect costs from caregiver questionnaires plus hospital records. In total, 792 children were included (692 non-severe, 52 severe, 48 life-threatening), with RSV confirmed in sizeable shares across groups (19%, 37%, and 29%, respectively).

From a societal perspective, average costs per RSV episode were estimated at US$13 for non-severe cases, US$244 for severe cases, and US$179 for life-threatening cases (2023 USD). Notably, costs did not rise neatly with severity—partly because the life-threatening group included fatalities with low incurred costs and small sample sizes. The household burden was stark: for severe RSV, average household costs exceeded 200% of Nigeria’s national monthly minimum wage, and 89% of households reported relying on personal savings to pay. For immunization and prevention decision-makers, the message is clear: even when per-episode costs appear modest in outpatient care, severe disease can be financially catastrophic—data that can directly strengthen health economic evaluations and budget impact analyses for emerging RSV immunization and passive immunization strategies in Nigeria and similar settings.

Thumbnail image credit: Shutterstock / Oni Abimbola