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

@article{majowicz2026estimates,
  title = {{WHO estimates of the global, regional, and national burden of 14 foodborne diarrhoeal enteric hazards, 2000–21: an updated data synthesis}},
  author = {Shannon Elizabeth Majowicz and Josh Michael Colston and Martyn Kirk and Sara Monteiro Pires and Yuki Minato and Luria Leslie Founou and Brecht Devleesschauwer and Carlotta Di Bari and Teresa Estrada‐García and Louise Vaes and Arie Hendrik Havelaar and Charlee Law and Tesfaye Gobena and Ashok Kumar and Fadi Al Natour and Robin Lake and Gabriela F. Nane and Lucy Jane Robertson and Kim Fernandez and Elaine Scallan Walter and Margaret N. Kosek and Antonio Agudo and Mohammed Al Huthiel and Fadi Al Natour and Li Bai and Beau Bruce and Brecht Devleesschauwer and Sithar Dorjee and Teresa Estrada-Garcia and Luria Leslie Founou and Tesfaye Gobena and Sandra Hoffmann and Lea Sletting Jakobsen and Karen Keddy and Martyn Kirk and Mirjam Kretzschmar and Kunihiro Kubota and Ashok Kumar and R. Lake and Shannon E Majowicz and Lapo Mughini‐Gras and Sara Monteiro Pires and Tety Rachmawati and Lucy Robertson and Elaine Scallan Walter and Banchob Sripa and Fadi Al Natour and Teresa Estrada-Garcia and Luria Leslie Founou and Tesfaye Gobena and Martyn Kirk and Ashok Kumar and Shannon E Majowicz and Sara Monteiro Pires and Elaine Scallan Walter},
  journal = {The Lancet Global Health},
  year = {2026},
  month = jun,
  doi = {10.1016/j.langlo.2026.103997},
  url = {https://doi.org/10.1016/j.langlo.2026.103997},
  note = {CC BY},
}

TY  - JOUR
TI  - WHO estimates of the global, regional, and national burden of 14 foodborne diarrhoeal enteric hazards, 2000–21: an updated data synthesis
AU  - Shannon Elizabeth Majowicz
AU  - Josh Michael Colston
AU  - Martyn Kirk
AU  - Sara Monteiro Pires
AU  - Yuki Minato
AU  - Luria Leslie Founou
AU  - Brecht Devleesschauwer
AU  - Carlotta Di Bari
AU  - Teresa Estrada‐García
AU  - Louise Vaes
AU  - Arie Hendrik Havelaar
AU  - Charlee Law
AU  - Tesfaye Gobena
AU  - Ashok Kumar
AU  - Fadi Al Natour
AU  - Robin Lake
AU  - Gabriela F. Nane
AU  - Lucy Jane Robertson
AU  - Kim Fernandez
AU  - Elaine Scallan Walter
AU  - Margaret N. Kosek
AU  - Antonio Agudo
AU  - Mohammed Al Huthiel
AU  - Fadi Al Natour
AU  - Li Bai
AU  - Beau Bruce
AU  - Brecht Devleesschauwer
AU  - Sithar Dorjee
AU  - Teresa Estrada-Garcia
AU  - Luria Leslie Founou
AU  - Tesfaye Gobena
AU  - Sandra Hoffmann
AU  - Lea Sletting Jakobsen
AU  - Karen Keddy
AU  - Martyn Kirk
AU  - Mirjam Kretzschmar
AU  - Kunihiro Kubota
AU  - Ashok Kumar
AU  - R. Lake
AU  - Shannon E Majowicz
AU  - Lapo Mughini‐Gras
AU  - Sara Monteiro Pires
AU  - Tety Rachmawati
AU  - Lucy Robertson
AU  - Elaine Scallan Walter
AU  - Banchob Sripa
AU  - Fadi Al Natour
AU  - Teresa Estrada-Garcia
AU  - Luria Leslie Founou
AU  - Tesfaye Gobena
AU  - Martyn Kirk
AU  - Ashok Kumar
AU  - Shannon E Majowicz
AU  - Sara Monteiro Pires
AU  - Elaine Scallan Walter
PY  - 2026
DA  - 2026/06/15
JO  - The Lancet Global Health
DO  - 10.1016/j.langlo.2026.103997
UR  - https://doi.org/10.1016/j.langlo.2026.103997
AB  - 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.
SN  - 2214-109X
SN  - 2572-116X
ER  -