article · The Lancet Infectious Diseases
This study estimated the global burden of non-typhoidal salmonella invasive disease (iNTS) for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Researchers conducted a systematic review and used a Bayesian meta-regression tool to estimate iNTS incidence and mortality from 1990 to 2017, considering age, sex, and geographical location. They found an estimated 535,000 cases and 77,500 deaths globally in 2017, with the highest incidence in sub-Saharan Africa and among children younger than five years. Case fatality rates were particularly high in children, elderly people, and individuals with HIV infection, highlighting the significant impact of this disease.
This research quantifies the significant global health threat posed by non-typhoidal salmonella invasive disease, particularly in vulnerable populations. Understanding its burden is crucial for public health planning and resource allocation to develop effective prevention and control strategies, ultimately saving lives and reducing illness worldwide.
The abstract indicates that understanding the sources and transmission pathways of non-typhoidal salmonella invasive disease is crucial for developing effective preventive and control measures. This suggests a need for further research into diagnostics, surveillance tools, and public health interventions. It is early-stage research informing public health strategy rather than identifying a specific near-market product.
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BACKGROUND: Non-typhoidal salmonella invasive disease is a major cause of global morbidity and mortality. Malnourished children, those with recent malaria or sickle-cell anaemia, and adults with HIV infection are at particularly high risk of disease. We sought to estimate the burden of disease attributable to non-typhoidal salmonella invasive disease for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. METHODS: We did a systematic review of scientific databases and grey literature, and estimated non-typhoidal salmonella invasive disease incidence and mortality for the years 1990 to 2017, by age, sex, and geographical location using DisMod-MR, a Bayesian meta-regression tool. We estimated case fatality by age, HIV status, and sociodemographic development. We also calculated the HIV-attributable fraction and estimated health gap metrics, including disability-adjusted life-years (DALYs). FINDINGS: We estimated that 535 000 (95% uncertainty interval 409 000-705 000) cases of non-typhoidal salmonella invasive disease occurred in 2017, with the highest incidence in sub-Saharan Africa (34·5 [26·6-45·0] cases per 100 000 person-years) and in children younger than 5 years (34·3 [23·2-54·7] cases per 100 000 person-years). 77 500 (46 400-123 000) deaths were estimated in 2017, of which 18 400 (12 000-27 700) were attributable to HIV. The remaining 59 100 (33 300-98 100) deaths not attributable to HIV accounted for 4·26 million (2·38-7·38) DALYs in 2017. Mean all-age case fatality was 14·5% (9·2-21·1), with higher estimates among children younger than 5 years (13·5% [8·4-19·8]) and elderly people (51·2% [30·2-72·9] among those aged ≥70 years), people with HIV infection (41·8% [30·0-54·0]), and in areas of low sociodemographic development (eg, 15·8% [10·0-22·9] in sub-Saharan Africa). INTERPRETATION: We present the first global estimates of non-typhoidal salmonella invasive disease that have been produced as part of GBD 2017. Given the high disease burden, particularly in children, elderly people, and people with HIV infection, investigating the sources and transmission pathways of non-typhoidal salmonella invasive disease is crucial to implement effective preventive and control measures. FUNDING: Bill & Melinda Gates Foundation.
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DOI: 10.1016/s1473-3099(19)30418-9
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