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Published on: November 7, 2018

Global and Regional Trends of Pediatric Enteric Infections, 1990-2021: Rising Modeled Burden of Invasive

Wensi Fan1, Kai Wang2, Tingting Tan1

  • 1Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.

Foodborne Pathogens and Disease
|July 23, 2026
PubMed

Insights

Global enteric infections in children show mixed trends. While diarrheal diseases and typhoid fever declined, invasive non-typhoidal Salmonella infections increased globally, particularly in high-income regions, necessitating enhanced surveillance.

Area of Science:

  • Global health
  • Infectious diseases epidemiology
  • Pediatric infectious diseases

Background:

  • Enteric infections pose a significant global health burden, especially in children.
  • Understanding incidence trends of diarrheal diseases (DD), typhoid/paratyphoid fever (TP), and invasive non-typhoidal Salmonella (iNTS) is crucial for public health interventions.
  • Previous studies often lack a pediatric-specific focus and direct comparison between these enteric pathogens.

Purpose of the Study:

  • To assess global and regional incidence trends of DD, TP, and iNTS in children aged 0-14 years from 1990 to 2021.
  • To characterize temporal, regional, and socioeconomic patterns of these infections.
  • To contrast pediatric-specific iNTS trends with those of DD and TP.

Main Methods:

  • Utilized data from the Global Burden of Disease (GBD) 2021 study for enteric infection incidence.
  • Analyzed age-standardized incidence rates (ASIRs) and average annual percentage changes (AAPCs).
  • Examined correlations between the socio-demographic index (SDI) and ASIRs to identify socioeconomic patterns.

Main Results:

  • Globally, DD and TP incidence declined, while iNTS incidence increased by 45.14% from 1990 to 2021.
  • The global AAPC for iNTS was 0.951%, with the highest increases observed in high-SDI regions, Western Europe, high-income Asia Pacific, and North America.
  • Countries like the UK showed significant iNTS AAPC increases, whereas regions with historically high iNTS burden, such as Western sub-Saharan Africa, exhibited declining trends.

Conclusions:

  • Despite overall declines in DD and TP, iNTS shows concerning modeled increases globally and in high-income areas among children.
  • These pediatric-specific findings contrast with previous all-age analyses and highlight regional disparities.
  • The rise in iNTS in high-income regions warrants urgent attention, including enhanced surveillance, serovar identification, and antimicrobial resistance monitoring.

Keywords:
enteric infectionsglobal incidencehigh-income regionsinvasive non-typhoidal Salmonellasocio-demographic index

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