Purpose: The objective of this study was to provide estimates of the global and regional incidence and mortality of diarrheal diseases caused by nine pathogens that are commonly transmitted through foods.
Methods: We abstracted data from systematic reviews and national estimates of foodborne diseases and, depending on mortality rates of the country, applied either a national incidence estimate or a modified Child Health Epidemiology Reference Group (CHERG) approach to estimate the etiology-specific incidence and mortality of diarrheal diseases, by age and region.
Results: The nine diarrheal diseases assessed caused 1.8 billion (95% uncertainty interval [UI] 1.1 – 3.3 billion) cases and around 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), ETEC (233 million; 95% UI 154 – 380 million), Shigella spp. (188 million; 95% UI 94 – 379 million) and G. 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 Escherichia coli (121,455; 95% UI 103,657 – 143,348), enterotoxigenic E. coli (73,041; 95% UI 55,474 – 96,984) and Shigella (64,993; 95% UI 48,966 – 92,357). There were marked regional differences in incidences and mortality for several diseases. Nearly 40% of diarrheal disease cases and 43% of diarrheal disease deaths occurred in children under five years of age.
Significance: Diarrheal diseases caused by nine pathogens commonly transmitted through food are responsible for a large disease burden, particularly in children. These etiology-specific burden estimates can inform efforts to reduce foodborne diarrheal diseases.