Peer-reviewed article
WHO estimates of the global, regional, and national burden of 14 foodborne diarrhoeal enteric hazards, 2000-21: an updated data synthesis.
Majowicz SE, Colston JM, Kirk MD, Pires SM, Minato Y et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This WHO study estimates the global burden of 14 foodborne diseases that cause diarrhoea across 194 countries from 2000 to 2021. In 2021, these pathogens caused 666 million illnesses, 265,000 deaths, and 15.2 million disability-adjusted life-years globally. Children under 5 years old experience dramatically higher mortality and disease burden than older children and adults, with the African region most severely affected. While the overall burden has declined since 2000, these diarrhoeal diseases remain a major cause of child illness and death, particularly in low-income countries.
Key points
- In 2021, 14 foodborne diarrhoeal hazards caused 666 million illnesses, 265,000 deaths, and 15.2 million DALYs globally
- Mortality rates were 7.1 times higher and DALY rates 18.9 times higher in children younger than 5 years compared to older populations
- The African region has the greatest disease burden at 773.5 DALYs per 100,000 population from foodborne transmission
- Shigella, Campylobacter, and rotavirus caused the most DALYs from foodborne transmission
- Overall foodborne burden decreased between 2000 and 2021, but this trend was inconsistent across different hazards
Limitations
This report estimates disease burden rather than evaluating an intervention, so it does not provide evidence on what works to prevent or treat these diseases. The estimates depend on the quality and availability of underlying data which varies substantially by country and region.
Abstract
Background Foodborne diseases cause significant illness and death globally. We updated WHO estimates of the burden caused by diarrhoeal hazards commonly transmitted by food: Campylobacter jejuni, Campylobacter coli, and other thermotolerant Campylobacter species; Cryptosporidium spp; Cyclospora cayetanensis; Entamoeba histolytica; enteroaggregative Escherichia coli; enteropathogenic E coli; enterotoxigenic E coli; Giardia duodenalis; norovirus; rotavirus; non-typhoidal Salmonella enterica; Shiga toxin-producing E coli; Shigella spp; and Vibrio cholerae. Methods We estimated illnesses, deaths, and disability-adjusted life-years (DALYs) for 194 countries for the period 2000-21 using data from systematic reviews; the Global Burden of Diseases, Injuries, and Risk Factors Study 2021; a structured expert judgement study; and country consultations. We used disease-specific computational models, and a hierarchical meta-regression model with geographical clustering, a global linear time trend, and uncertainty propagation. Findings In 2021, the 14 diarrhoeal hazards caused 666 million (95% UI 483-884) illnesses, 265 000 deaths (196 000-351 000), and 15·2 million (11·6-19·1) DALYs from foodborne transmission. Shigella spp, Campylobacter, and rotavirus caused the most DALYs from foodborne transmission. The greatest burden was in the African region (773·5 DALYs [95% UI 559·7-1033·3] per 100 000 population due to foodborne transmission). Mortality rates were 7·1 times higher and DALY rates 18·9 times higher in children younger than 5 years than in people aged 5 years or older. While the overall foodborne burden decreased between 2000 (692·3 DALYs [517·9-938·1] per 100 000 population) and 2021 (193·6 [147·2-243·0] per 100 000), this trend was not consistent for all hazards. Interpretation Diarrhoeal hazards continue to cause a substantial foodborne disease burden, despite decreases over time. Children in low-income countries bear the greatest burden. Prevention requires concerted efforts, including expanding global diarrhoeal disease prevention efforts beyond water, sanitation, and hygiene and vaccination to include improvements in the safety of the food supply. Funding WHO.