Aetiology-Specific Estimates of the Global and Regional Incidence and Mortality of Diarrhoeal Diseases Commonly Transmitted through Food
Open accessAbstract
BACKGROUND: Diarrhoeal diseases are major contributors to the global burden of disease, particularly in children. However, comprehensive estimates of the incidence and mortality due to specific aetiologies of diarrhoeal diseases are not available. The objective of this study is to provide estimates of the global and regional incidence and mortality of diarrhoeal diseases caused by nine pathogens that are commonly transmitted through foods. METHODS AND FINDINGS: We abstracted data from systematic reviews and, depending on the overall mortality rates of the country, applied either a national incidence estimate approach or a modified Child Health Epidemiology Reference Group (CHERG) approach to estimate the aetiology-specific incidence and mortality of diarrhoeal diseases, by age and region. The nine diarrhoeal diseases assessed caused an estimated 1.8 billion (95% uncertainty interval [UI] 1.1-3.3 billion) cases and 599,000 (95% UI 472,000-802,000) deaths worldwide in 2010. The largest number of cases were caused by norovirus (677 million; 95% UI 468-1,153 million), enterotoxigenic Escherichia coli (ETEC) (233 million; 95% UI 154-380 million), Shigella spp. (188 million; 95% UI 94-379 million) and Giardia lamblia (179 million; 95% UI 125-263); the largest number of deaths were caused by norovirus (213,515; 95% UI 171,783-266,561), enteropathogenic E. coli (121,455; 95% UI 103,657-143,348), ETEC (73,041; 95% UI 55,474-96,984) and Shigella (64,993; 95% UI 48,966-92,357). There were marked regional differences in incidence and mortality for these nine diseases. Nearly 40% of cases and 43% of deaths caused by these nine diarrhoeal diseases occurred in children under five years of age. CONCLUSIONS: Diarrhoeal diseases caused by these nine pathogens are responsible for a large disease burden, particularly in children. These aetiology-specific burden estimates can inform efforts to reduce diarrhoeal diseases caused by these nine pathogens commonly transmitted through foods.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Murray, C. J. L., Vos, T., Lozano, R., Naghavi, M., Flaxman, A. D., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61689-4 · Cited by 8,888 · see citing works
Global burden of childhood pneumonia and diarrhoea
Walker, C. L. F., Rudan, I., Liu, L., Nair, H., Theodoratou, E., Bhutta, Z. A., O'Brien, K. L., Campbell, H., & Black, R. E. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60222-6 · Cited by 2,356 · cited 2× · see citing works
“First, we identified the total number of diarrhoeal cases in the 133 countries for 2010 by combining estimates based on systematic reviews for children<5 years of age and persons 5 years of age [3,4].”
BackgroundMethodSelf-citationDisease burden of foodborne pathogens in the Netherlands, 2009
Havelaar, A. H., Haagsma, J. A., Mangen, M.-J. J., Kemmeren, J. M., Verhoef, L. P. B., Vijgen, S. M. C., Wilson, M., Friesema, I. H. M., Kortbeek, L. M., van Duynhoven, Y. T. H. P., et al. (2012) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2012.03.029 · Cited by 380 · see citing works
Evolving public health approaches to the global challenge of foodborne infections
Tauxe, R. V., Doyle, M. P., Kuchenmüller, T., Schlundt, J., & Stein, C. E. (2010) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2009.10.014 · Cited by 201 · see citing works
Foodborne illness, Australia, circa 2000 and circa 2010
Kirk, M., Ford, L., Glass, K., & Hall, G. (2014) · Emerging Infectious Diseases · doi:10.3201/eid2011.131315 · Cited by 137 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 16
- [3]Fisher-Walker CL, Black RE. Diarrhoea morbidity and mortality in older children, adolescents, and adults. Epidemiology and infection. 2010 9; 138(9): 1215– 26. 10.1017/S0950268810000592 20307341 · DOI
- [5]Lanata CF, Fischer-Walker CL, Olascoaga AC, Torres CX, Aryee MJ, Black RE, et al Global causes of diarrhoeal disease mortality in children <5 years of age: a systematic review. PloS one. 2013; 8(9): e72788 Pubmed Central PMCID: 3762858. 10.1371/journal.pone.0072788 24023773 PMC3762858 · DOI
- [6]Fischer Walker CL, Sack D, Black RE. Etiology of diarrhea among older children, adolescents, and adults: a systematic review. PLoS Negl Trop Dis 2010; 4(8): e768 10.1371/journal.pntd.0000768 20689809 PMC2914743 · DOI
- [7]Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, et al Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. The Lancet 2013 10.1016/S0140-6736(13)60844-2 23680352 · DOI · Paper page
- [8]Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM. Foodborne illness acquired in the United States—unspecified agents. Emerg Infect Dis, 2011 17(1): p. 16– 22. 10.3201/eid1701.091101p2 21192849 PMC3204615 · DOI
- [10]Tam CC, Rodrigues LC, Viviani L, Dodds JP, Evans MR, Hunter PR, et al Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice. Gut, 2012 61(1): p. 69– 77. 10.1136/gut.2011.238386 21708822 PMC3230829 · DOI
- [11]Thomas MK, Murray R, Flockhart L, Pintar K, Pollari F, Fazil A, et al, Estimates of the burden of foodborne illness in Canada for 30 specified pathogens and unspecified agents, circa 2006. Foodborne Pathog Dis, 2013 10(7): p. 639– 48. 10.1089/fpd.2012.1389 23659355 PMC3696931 · DOI · Paper page
- [13]Vaillant V, de Valk H, Baron E, Ancelle T, Colin P, Delmas MC, et al Foodborne infections in France. Foodborne Pathog Dis, 2005 2(3): p. 221– 32. 16156703
- [14]Lake RJ, Cressey PJ, Campbell DM, Oakley E. Risk ranking for foodborne microbial hazards in New Zealand: burden of disease estimates. Risk Anal, 2010 30(5): p. 743– 52. 10.1111/j.1539-6924.2009.01269.x 19645753 · DOI
- [15]Majowicz SE, Scallan E, Jones-Bitton A, Sargeant JM, Stapleton J, Angulo FJ, et al Global Incidence of Human Shiga Toxin-Producing Escherichia coli Infections and Deaths: A Systematic Review and Knowledge Synthesis. Foodborne pathogens and disease. 2014 4 21; 11(6): 447– 55. 10.1089/fpd.2013.1704 24750096 PMC4607253 · DOI
- [16]Ali M, Lopez AL, You YA, Kim YE, Sah B, Maskery B, et al The global burden of cholera. Bull World Health Organ. 2012 3 1; 90(3): 209– 18A. Pubmed Central PMCID: 3314202. 10.2471/BLT.11.093427 22461716 PMC3314202 · DOI
- [17]Ahmed SM, Hall AJ, Robinson AE, Verhoef L, Parashar UD, Koopmans M, et al The global prevalence of norovirus among cases of gastroenteritis. Lan Infect Dis, 2014. In press. PMC8006533 24981041
- [18]Flint JA, Duynhoven YTV, Angulo FJ, DeLong SM, Braun P, Kirk M, et al Estimating the Burden of Acute Gastroenteritis, Foodborne Disease, and Pathogens Commonly Transmitted by Food: An International Review. Clin Infect Dis. 2005 41 (5): 698– 704. 16080093
- [19]Lopman B, Simmons K, Gambhir M, Vinjé J, Parashar U. Epidemiologic implications of asymptomatic reinfection: a mathematical modeling study of norovirus. Am J Epidemiol, 2014 179: 507– 512. 10.1093/aje/kwt287 24305574 · DOI
- [20]Platts-Mills JA, Babji S, Bodhidatta L, Gratz J, Haque R, Havt A, et al Pathogen-specific c burdens of community diarrhoea in developing countries: a multisite birth cohort study (MAL-ED). Lancet Global Health 3: e564– e575. 10.1016/S2214-109X(15)00151-5 26202075 PMC7328884 · DOI
- [21]Pires S.M. Assessing the applicability of currently available methods for attributing foodborne disease to sources, including food and food commodities. Foodborne Pathog Dis, 2013 10(3): p. 206– 13. 10.1089/fpd.2012.1134 23489045 · DOI
Cited by
Sorted by citations
Kirk, M. D., Pires, S. M., Black, R. E., Caipo, M., Crump, J. A., Devleesschauwer, B., Döpfer, D., Fazil, A., Fischer-Walker, C. L., Hald, T., et al. (2015) · PLoS Medicine · doi:10.1371/journal.pmed.1001921 · Cited by 1,625 · see citing works
“Where data sources were not available, the EDTF recommended that WHO commission systematic reviews into incidence and outcomes of specific agents, which were subsequently published in the peer-reviewed literature [11 – 22].”
InfluentialSelf-citationHigh Throughput Sequencing for Detection of Foodborne Pathogens
Sekse, C., Holst-Jensen, A., Dobrindt, U., Johannessen, G. S., Li, W., Spilsberg, B., & Shi, J. (2017) · Frontiers in Microbiology · doi:10.3389/fmicb.2017.02029 · Cited by 98 · see citing works
Consumer knowledge, attitudes, and behaviour regarding food safety – A perspective from Laos
Kasza, G., Izsó, T., Kunszabó, A., Szakos, D., Lénárt, I., Bozánné Békefi, E., Vongxay, K., Popp, J., Oláh, J., Lakner, Z., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e29725 · Cited by 19 · see citing works
- Authors
- Pires, S. M., Fischer-Walker, C. L., Lanata, C. F., Devleesschauwer, B., Hall, A. J., Kirk, M. D., Duarte, A. S. R., Black, R. E., & Angulo, F. J.
- Affiliations
- Technical University of Denmark (DK)
- Johns Hopkins University (US)
- Instituto de Investigación Nutricional (PE)
- Ghent University (BE)
- Centers for Disease Control and Prevention (US)
- Australian National University (AU)
- Corresponding author
- Pires, Sara M.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-12-03
- Volume
- 10
- Issue
- 12
- Pages
- e0142927
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4668836
- OpenAlex
- W2191139669
- Cited by
- 445
- References
- 5
- Citations by year
- 2026: 30 · 2025: 49 · 2024: 43 · 2023: 48 · 2022: 42 · 2021: 60 · 2020: 39 · 2019: 48 · 2018: 42 · 2017: 26 · 2016: 16 · 2015: 2
- FWCI
- 22.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- ANU Open Research (Australian National University) (submittedVersion)
- Technical University of Denmark, DTU Orbit (Technical University of Denmark, DTU) (submittedVersion, other-oa)
- Funders
- U.S. Department of Defense
- Bill and Melinda Gates Foundation
- World Health Organization
- Centers for Disease Control and Prevention
- U.S. Navy
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral gastroenteritis research and epidemiology
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- diarrhoeal diseases, foodborne pathogens, incidence estimation, mortality estimation, norovirus, enterotoxigenic Escherichia coli, enteropathogenic Escherichia coli, Shigella, Giardia lamblia, global burden of disease, child mortality, regional variation, children under five, age-standardized incidence, diarrhea
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Child, Preschool, Diarrhea, Dysentery, Bacillary, Escherichia coli Infections, Female, Foodborne Diseases, Gastroenteritis, Giardiasis, Humans, Infant, Infant, Newborn, Male, Middle Aged, Shigella, Global Health, Incidence, Giardia lamblia, Caliciviridae Infections, Cost of Illness, Norovirus, Enterotoxigenic Escherichia coli, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
