title: Aetiology-Specific Estimates of the Global and Regional Incidence and Mortality of Diarrhoeal Diseases Commonly Transmitted through Food.
abstract: 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.
  
  
  RESULTS
  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.
authors.affiliation: National Food Institute, Danish Technical University, Copenhagen, Denmark.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Pires
authors.affiliation: Johns Hopkins University, Baltimore, United States of America.
authors.forename: Christa L
authors.initials: CL
authors.lastname: Fischer-Walker
authors.affiliation: Instituto de Investigación Nutricional, Lima, Peru.|US Naval Medical Research Unit No. 6, Callao, Peru.
authors.forename: Claudio F
authors.initials: CF
authors.lastname: Lanata
authors.affiliation: Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Institute of Health and Society (IRSS), Faculty of Public Health, Université Catholique de Louvain, Brussels, Belgium; Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Brecht
authors.initials: B
authors.lastname: Devleesschauwer
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Aron J
authors.initials: AJ
authors.lastname: Hall
authors.affiliation: The Australian National University, Canberra, Australia.
authors.forename: Martyn D
authors.initials: MD
authors.lastname: Kirk
authors.affiliation: National Food Institute, Danish Technical University, Copenhagen, Denmark.
authors.forename: Ana S R
authors.initials: AS
authors.lastname: Duarte
authors.affiliation: Johns Hopkins University, Baltimore, United States of America.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Angulo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000401:mortality; D054307:Enterotoxigenic Escherichia coli; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005759:Gastroenteritis / Q000453:epidemiology* / Q000401:mortality; D016829:Giardia lamblia; D005873:Giardiasis / Q000453:epidemiology* / Q000401:mortality; D014943:Global Health; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D029322:Norovirus; D012760:Shigella; D055815:Young Adult