Respiratory Syncytial Virus–Associated Hospitalizations in Children Under Five in Erbil City, Iraq: A Cross-Sectional Study

Respiratory syncytial virus (RSV) is a predominant etiological agent of acute respiratory tract infections (ARTI) in young children associated with elevated hospitalization rates. Rapid detection of the virus decreases serious complications. This study was conducted to investigate the incidence of RSV infection in pediatric patients and related demographic and clinical criteria through rapid RSV antigen detection in Erbil city/Iraq. A cross-sectional study performed within the 1st of December 2024, to the 28th of February 2025. It involved 177 children under 5 years who presented with signs of ARTI and visited Raparin Teaching Hospital for children in Erbil city. Nasopharyngeal specimens were collected and tested for RSV antigen using the Combo rapid test (Biotech, China). Approximately 72.4% of RSV-positive patients were hospitalized, with bronchiolitis being the most common clinical diagnosis. RSV infection was significantly higher in infants ≤6 months (53.3%, p<0.001). Higher rates of RSV infection were recorded in infants with artificial feeding (51.7%) and delivered by cesarean section (63.8%). Dyspnea was a significant sign in RSV-associated hospitalizations (p=0.002). RSV infection peaked in January despite higher ARTI rates in December (p<0.01). RSV was a leading winter pathogen in young children with high hospitalization rates. The Combo rapid test offered a quick, cost-effective tool for multi-virus detection.