Global burden of enteric infectious diseases, diarrhoeal diseases, and corresponding aetiologies, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023
Articolo
Data di Pubblicazione:
2026
Abstract:
Background: Enteric infectious diseases claim more than 1 million lives annually and are among the top ten causes of death in children younger than 5 years. Remarkable global investment has been dedicated to enteric infectious disease prevention and control; however, the shifting global health landscape is testing the continuance of progress. To evaluate the current status and guide future interventions, we present the latest epidemiological estimates of enteric infectious diseases from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 and assess progress towards the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) mortality target of fewer than 20 deaths per 100 000 children younger than 5 years by 2025. Methods: We quantified the incidence, mortality, and disability-adjusted life-years (DALYs) of enteric infectious diseases by age, sex, and year across 204 countries and territories from 1990 to 2023. In GBD 2023, the following were considered under the category of enteric infectious diseases: diarrhoeal diseases, enteric fever (typhoid and paratyphoid), invasive non-typhoidal Salmonella spp (iNTS) infections, and other intestinal infectious diseases. We also examined 15 aetiologies contributing to diarrhoeal diseases. Incidence and prevalence were estimated with DisMod-MR (version 2.1), a Bayesian meta-regression tool, drawing on data from systematic reviews, population-based surveys, claims data, and hospital sources. Cause-specific mortality was modelled with Cause of Death Ensemble Modelling based on data from sources including vital registration, mortality surveillance, verbal autopsy, and minimally invasive tissue sampling. Years of life lost and years lived with disability were computed and combined to derive DALYs. For aetiology-specific estimation, population-attributable fractions (PAFs) for 15 pathogens were derived with a counterfactual framework. Point estimates and 95% uncertainty intervals (UIs) were generated from 250 draws from the posterior distribution. Findings: In 2023, enteric infectious diseases resulted in an estimated 1·27 million (95% UI 0·963-1·68) deaths globally, declining from 3·69 million (3·04-4·56) in 1990. The global age-standardised mortality rate (ASMR) decreased from 74·1 (62·0-92·9) per 100 000 population to 16·4 (12·6-21·3) per 100 000 population during the same period. Diarrhoeal diseases accounted for most deaths in 2023 (1·11 million [0·811-1·54]), followed by enteric fever and iNTS. South Asia and sub-Saharan Africa remained the most affected regions in 2023, with 599 000 (441 000-882 000) and 501 000 (373 000-648 000) deaths due to enteric infectious diseases, respectively, predominantly from diarrhoeal disease. Rotavirus was the leading cause of all-age diarrhoeal disease deaths (PAF 16·3% [12·0-21·5]), followed by norovirus (10·2% [2·4-17·0]) and Shigella spp (9·3% [5·4-15·2]). Among children younger than 5 years, PAFs of deaths due to diarrhoeal diseases were 40·2% (32·5-48·5) for rotavirus, 24·0% (15·1-36·7) for Shigella spp, and 23·4% (13·7-34·3) for adenovirus. Across 204 countries and territories, 141 met the GAPPD mortality target in 2023. The driving aetiologies among countries that did not meet the target in 2023 varied slightly by GBD super-region, but the highest or second-highest number of deaths in children younger than 5 years were consistently attributed to rotavirus. Astrovirus and sapovirus, newly included in GBD 2023, were responsible for 24 600 (6290-49 000) and 18 800 (4650-44 400) deaths, respectively, in 2023, mainly in children younger than 5 years. Interpretation: Our findings show that mortality and ASMRs of enteric infectious diseases decline
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Articolo su Rivista
Elenco autori:
Vongpradith, Avina; Dominguez, Regina-Mae Villanueva; Tudor Car, Lorainne; Movo, Amanda; Ostroff, Samuel M; He, Jiawei; Albertson, Samuel B; Carter, Austin; Bisignano, Catherine; A, Bhoomadevi; Aalruz, Hasan; Abate, Belayneh Jejaw; Abbasi, Madineh; Abd Elhafeez, Samar; Abdallah, Emad M; Abdelgadir, Abdelmuhsin; Abdelgalil, Ahmed Abdelrahman; Abdel-Hameed, Reda; Abdellatif, Ahmed Ah; Abdelwahab, Omar Ahmed; Abdelwahab, Siddig Ibrahim; Abdisa, Wakgari Mosisa; Abdous, Arman; Abdul Aziz, Jeza Muhamad; Abdul-Ghani, Rashad; Abduljelil, Abdulbasit Sherfa; Abdulkader, Rizwan Suliankatchi; Abdullah, Null; Abdullahi, Auwal; Abdulrahim, Abdulrakib; Abdulrahman, Rezheen Fatah; Abdulrahman, Zirak Ahmed; Abdul-Rahman, Toufik; Abdulwehab, Sadik; Abdykerimova, Kulmira; Abebe, Meklit Girma; Abebe, Melese Shenkut; Abejew, Asrat Agalu; Abere, Yirgalem; Abidi, Syed Hani; Abil, Olifan Zewdie; Abiodun, Olumide; Aboagye, Richard Gyan; Abolhassani, Hassan; Aborode, Abdullahi Tunde; Abourashed, Nagah M; Abtahi, Dariush; Abu Lila, Amr Selim; Abuadas, Fuad Hamdi A; Abuarqoub, Alqassem H; Abu-Elala, Nermeen; Abu-Farha, Rana Kamal; Abu-Gharbieh, Eman; Abuhammad, Sawsan; Abuhelwa, Ahmad Y; Abukhadijah, Hana J; Abushanab, Dina; Acharya, Anirudh Balakrishna; Acharya, Krishna Prasad; Acharya, Swetha; Adams, Lisa C; Adamu, Abdu A; Adamu, Aishah Fadila; Adamu, Yau; Addo, Isaac Yeboah; Adebisi, Tajudeen Adesanmi; Adebiyi, Babatope Oluwadamilare; Adebowale, Ayo Stephen; Adebowale, Oluwawemimo Oluseun; Adedia, David; Adedokun, Kamoru Ademola; Adegbile, Oluwatobi E; Adegoke, Nurudeen A; Adekanmbi, Victor; Adekola, Saheed Ayodeji; Adeleke, Olumide Thomas; Adeniyi, Makinde Adebayo; Adenusi, Adedeji; Adepoju, Adekola George; Adepoju, Daniel Adeyemi; Aderinoye-Rabiu, Rofiat Adewumi Adewumi; Adetunji, Charles Oluwaseun; Adhikary, Ripon Kumar; Adiga, Usha; Adisu, Molalign Aligaz Aligaz; Admassie, Belete Muluadam; Admassu, Kalkidan Yibeltal; Adnan, Mohd; Adnani, Qorinah Estiningtyas Sakilah; Adonteng-Kissi, Obed; Afrifa-Yamoah, Ebenezer; Afzal, Muhammad Sohail; Afzal, Saira; Afzal, Shairyar; Agbajelola, Victor Ibukun; Agde, Zeleke Dutamo; Aggarwal, Navidha; Agide, Feleke Doyore; Agordoh, Percival Delali Delali; Agrawal, Piyush; Agyemang-Duah, Williams; Ahadi, Mahsa; Ahmad, Adamu Adamu; Ahmad, Aqeel; Ahmad, Irfan; Ahmad, Khurshid; Ahmad, Muayyad M; Ahmad, Saheem; Ahmad, Sajjad; Ahmad, Suhaib; Ahmad, Syed Sayeed; Ahmad, Tauseef; Ahmed, Akeem Olayiwola; Ahmed, Ali; Ahmed, Ayman; Ahmed, Gasha Salih; Ahmed, Haroon; Ahmed, Jahanzaib Mian; Ahmed, Mehrunnisha Sharif; Ahmed, Meqdad Saleh; Ahmed, Mohamed Sherif Ali; Ahmed, Mohammed; Ahmed, Mushood; Ahmed, Naveed; Ahmed, Saif; Ahmed, Shahzaib; Ahmed, Syed Anees; Ahmed, Zohra; Ahmed El-Imam, Ibrahim; Aimagambetova, Gulzhanat; Akbarifard, Saeid; Akeju, Oluwabusayomi O; Akeju, Oluwasefunmi; Akhigbe, Roland Eghoghosoa; Akhtar, Muhammad Nadeem; Akhter, Mohsina; Akinosoglou, Karolina; Akintunde, Damilare Michael; Akram, Hammad; Al Athamneh, Ahmad; Al Awaidy, Salah; Al Hasan, Syed Mahfuz; Al Kubaisi, Khalid Awad; Al Maghaireh, Duaa Fayiz; Al Thaher, Yazan; Al Zoubi, Mohammad Ahmmad Mahmoud; Al Zoubi, Tariq; Al-Abbadi, Mousa Ali; Alabbas, Alhumaidi B; Al-Ahmad, Mohammad M; Alam, Khurshid; Alam, Mohammad Khursheed; Alam, Mohammad Jahoor; Alam, Rabail; Alanezi, Fahad Mashhour; Alansari, Amani N; Alanzi, Turki M; Alao, Jude Oluwapelumi; Al-Ashwal, Fahmi Y; Alavi, Seyedeh Shaghayegh; Al-Azayzih, Ahmad; Albashtawy, Mohammed; Albataineh, Mohammad T; Al-Buriahi, Ms Sultan; Al-Dewik, Nader; Aldhahir, Abdulelah Mastour; Aleidi, Shereen M; Alemseged, Embay Amare; Alenezi, Khalaf M; Alfalki, Ali M; Algammal, Abdelazeem M; Algethami, Mohammed Ridha; Al-Gheethi, Adel Ali Saeed; Alhalaiqa, Fadwa Naji; Alhumaidi, Ashraf; Ali, Aizaz; Ali, Haider; Ali, Haroon Muhammad; Ali, Inayat; Ali, Irfan; Ali, Kamran; Ali, Liaqat; Ali, Mohammad Daud; Ali, Mohammed Usman; Ali, Nemat; Ali, Syed Shujait; Ali, Taha Hussein Hussein; Al-Iede, Montaha; Alif, Sheikh Mohammad;
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