Global Burden of Upper Airway Infections: Epidemiology, Current Challenges and Future Perspectives

Upper airway tract infections (UATIs) are among the most common infectious diseases worldwide, accounting for an estimated 12.8 billion episodes annually and more than 8 million disability-adjusted life years (DALYs). Despite their generally self-limiting nature, their cumulative clinical, socioeconomic, and public health burden remains substantial, particularly in children, older adults, and low- and middle-income countries (LMICs).

We performed a structured narrative review of the peer-reviewed literature and reports from major international health organizations to summarize the current evidence on the epidemiology, etiology, clinical impact, socioeconomic burden, prevention strategies, and future challenges associated with UATIs. Particular attention was given to the influence of antimicrobial resistance, vaccination policies, and lessons learned from the COVID-19 pandemic.

UATIs remain one of the leading causes of healthcare utilization worldwide. Children experience the highest incidence, averaging 6-8 episodes annually, whereas vulnerable populations are at increased risk of complications and hospitalization. Marked geographical disparities persist, with LMICs experiencing a disproportionate burden due to limited healthcare access, lower vaccination coverage, and higher complication rates. Inappropriate antibiotic prescribing continues to accelerate antimicrobial resistance, while the COVID-19 pandemic profoundly altered the epidemiology of respiratory infections and demonstrated the effectiveness of non-pharmaceutical interventions. Advances in vaccination, antimicrobial stewardship, rapid diagnostics, and novel therapeutic strategies offer promising opportunities to reduce disease burden.

Reducing the global burden of UATIs requires integrated public health strategies combining equitable vaccine access, effective antimicrobial stewardship, strengthened healthcare systems, and sustained surveillance. Lessons learned from the COVID-19 pandemic provide a unique opportunity to improve preparedness for future respiratory outbreaks while addressing persistent regional inequalities in prevention and care.