Respiratory syncytial virus-associated hospital admissions by deprivation levels among children and adults in Scotland

Abstract

Abstract Background Socioeconomic deprivation may predispose individuals to respiratory tract infections (RTI). We aimed to estimate the number and rate of RSV-associated hospitalisations by socioeconomic status using the Scottish Index of Multiple Deprivation (SIMD). Methods Using national routine healthcare records and virological surveillance from 2010-2016, we used a time-series linear regression model and a direct measurement based on ICD-10 coded diagnoses to estimate RSV-associated hospitalisations by SIMD level and age and compared to influenza-associated hospitalisations. Results Using the model-based approach, we estimated an annual average rate per 1000 of 0.76 (95%CI: 0.43-0.90) for individuals of all ages in the least deprived group (5th quintile of SIMD) to 1.51 (1.03-1.79) for the most deprived group (1st quintile). Compared with the least deprived group, we estimated that the rate ratio (RR) was 1.96 (95%CI: 1.23-3.25), 1.60 (1.0-2.66), 1.35 (0.85-2.25), and 1.12 (0.7-1.85) in the 1st to 4th quintile. The pattern of RSV-associated RTI hospitalisation rates variation with SIMD was most pronounced in children aged 2 years and below. The ICD-10 direct measurement approach provided much lower rates than the model-based approach but yielded similar RR estimates between SIMD groups. Influenza-associated RTI hospitalisation rate generally increased with higher deprivation levels among individuals aged 1 year and older. Conclusion Higher RSV and influenza hospitalisation rates are seen in the Scottish population of higher deprived levels. The differences between deprivation levels are most pronounced in infants and young children for RSV, and are more apparent beyond the first year of life for influenza.