Evidence map›Paper›PMID 42296981›Full record

ArticleThe Lancet. Global health2026

WHO estimates of the global, regional, and national burden of 14 foodborne diarrhoeal enteric hazards, 2000-21: an updated data synthesis.

Shannon E Majowicz, Josh M Colston, Martyn D Kirk, Sara M Pires, Yuki Minato, Luria L Founou, Brecht Devleesschauwer, Carlotta di Bari, Teresa Estrada-Garcia, Louise Vaes and 13 more

Abstract read
In one paragraph

Article in The Lancet. Global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Shannon E MajowiczSchool of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada. Electronic address: smajowic@uwaterloo.ca.
Josh M ColstonDivision of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA.
Martyn D KirkNational Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
Sara M PiresNational Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark.
Yuki MinatoDepartment of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland.
Luria L FounouReproductive, Maternal, Newborn and Child Health (ReMARCH) Research Unit, Research Institute of the Centre of Expertise and Biological Diagnostic of Cameroon, Yaoundé, Cameroon; Infection & Global Health Division, School of Medicine, University of St Andrews, St Andrews, UK; Antimicrobial Research Unit, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Brecht DevleesschauwerDepartment of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium.
Carlotta di BariDepartment of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium.
Teresa Estrada-GarciaDepartment of Molecular Biomedicine, CINVESTAV-IPN, Mexico City, Mexico.
Louise VaesDepartment of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Arie H HavelaarEmerging Pathogens Institute, Global Food Systems Institute, Department of Animal Sciences, University of Florida, Gainesville, FL, USA.
Charlee RobertsDepartment of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland.
Tesfaye GobenaSchool of Environmental Health Sciences, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
Ashok KumarIndian Council of Agricultural Research, Krishi Bhavan, New Delhi, India.
Fadi Al NatourAbu Dhabi Agriculture and Food Safety Authority, Mohamed Bin Zayed City, Abu Dhabi, United Arab Emirates.
Robin J LakeInstitute of Public Health and Forensic Science, Christchurch, New Zealand.
Gabriela F NaneDelft Institute of Applied Mathematics, Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, Netherlands.
Lucy J RobertsonParasitology Unit, Department of Paraclinical Science, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway.
Kim FernandezDepartment of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Elaine Scallan WalterColorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Margaret KosekDivision of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA.
Foodborne Disease Burden Epidemiology Reference Group for 2021–2025
Enteric Diseases Task Force members

Funding

The Planetary Child Health Observatory: an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICsK01AI168493 · NIAID · UNIVERSITY OF VIRGINIA · PI Josh M Colston · 2023 to 2026
$519k
NIAID NIH HHS K01 AI168493
6 · The paper itself

Abstract

backgroundFoodborne 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.

methodsWe 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.

findingsIn 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.

interpretationDiarrhoeal 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.

fundingWHO.

Indexed as

DiarrheaFoodborne DiseasesGlobal HealthDisability-Adjusted Life YearsHumansWorld Health Organization

Identifiers

PMID42296981
PMCPMC13358865

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.