WHO estimates of the global, regional, and national foodborne burdens of 14 invasive parasitic diseases, 2000–21 : an updated data synthesis

Abstract

BACKGROUND : Over 10 years ago, WHO estimates of hazard-specific foodborne disease burdens showed that parasites exert considerable health burdens globally. We updated these estimates, focusing on 14 invasive parasitic diseases. METHODS : Incidences, deaths, and disability-adjusted life-year (DALY) burdens were estimated for each parasitic disease from 2000 to 2021, using data from systematic reviews and the Global Burden of Diseases, Injuries, and Risk Factors Study. For some diseases, structured expert judgement was used to estimate proportions of foodborne infection. Data were pooled via hierarchical meta-regression models with uncertainty propagated through Monte Carlo simulations following disease-specific computational models defined by incidence rates and probability parameters. FINDINGS : We estimated that 277 million illnesses were caused by potentially foodborne invasive parasites, with approximately 171 million attributable to foodborne transmission. Considerable heterogeneity by parasite, in magnitude and uncertainty, was observed. Of 4·89 million foodborne DALYs associated with these diseases, highest contributions were from Taenia solium (1·3 million) and Clonorchis sinensis (0·921 million), both also associated with most foodborne deaths. Burden was greatest in the region of the Americas, predominantly due to Chagas disease, followed by the African region, where neurocysticercosis-associated epilepsy caused most burden. Burdens decreased globally from 2000 to 2021, except in the Western Pacific region, where the burden, predominantly associated with clonorchiasis, is rising. INTERPRETATION : Foodborne parasitoses cause considerable suffering, with some populations and regions particularly at risk. These data provide a baseline by which effects of interventions can be assessed and emphasis directed to those parasites exerting the greatest burden.