Background: Respiratory tract infections significantly impact global child health, especially in children under five, and are primarily caused by viruses and atypical bacteria. These infections are influenced by environmental and socio-economic factors. This study reviews common respiratory infections in Iranian children, identifies contributing factors, and evaluates their status within a global context.
Materials and Methods: This narrative review involved a systematic search of major national and international databases, including PubMed, Scopus, Web of Science, WHO, Google Scholar, SID, and CIVILICA, covering studies published up to April 2025. Eligible articles in English and Persian addressing respiratory infections in Iranian children were independently screened by two reviewers based on predefined inclusion criteria. Data extraction and quality assessment were conducted collaboratively to ensure a thorough and accurate synthesis of the relevant evidence.
Results: Respiratory Syncytial Virus (RSV) was the most prevalent pathogen, detected in approximately 30% of hospitalized children, followed by Human Metapneumovirus (hMPV) at 10–20%, and Mycoplasma pneumoniae at around 4.7%. Environmental factors such as air pollution, parental smoking, and the use of solid fuels, together with socio-economic factors including poverty, limited healthcare access, and low caregiver awareness, as well as biological factors like young age, male sex, and malnutrition, significantly influence disease prevalence and severity. Asthma prevalence among Iranian children ranged from 6% to 8%, which is lower than global averages. These epidemiological patterns and risk factors largely mirror those seen in other developing countries; however, regional variations underscore the need for locally tailored intervention strategies.
Conclusion: Acute respiratory infections in Iranian children are primarily caused by RSV, hMPV, and Mycoplasma pneumoniae. Their occurrence and severity are influenced by environmental, socio-economic, biological, climatic, cultural, and healthcare factors. Therefore, targeted interventions should prioritize education, improved healthcare access, and reduction of environmental risks.