Estimated burden of acute gastroenteritis and foodborne gastroenteritis caused by non-typhoidal Salmonella enterica, Shigella and norovirus in Gansu Province, Northwest China

BACKGROUND: Information on the burden of disease caused by foodborne pathogens in Northwest China is limited. This study aims to estimate the burden of acute gastroenteritis (AGE) and foodborne salmonellosis, shigellosis and norovirus gastroenteritis in Gansu Province. METHODS: Using data from population surveys conducted during 2011-2015, the burden of AGE was estimated in Gansu Province. By determining the number of pathogen-specific cases from sentinel hospital surveillance conducted during 2014-2019, with adjustments applied for healthcare-seeking behavior and stool specimen submission based on data from population surveys, the burden of foodborne gastroenteritis caused by non-typhoidal Salmonella enterica, Shigella and norovirus in Gansu Province was calculated. A multiplier calculation model was developed, using Monte Carlo simulation to perform uncertainty estimation. RESULTS: The adjusted monthly prevalence of AGE was 4.0%, equivalent to an average of 0.53 episodes of AGE per person-year in the region. The multiplier for salmonellosis was estimated at 1,739, for shigellosis at 1,646, and for norovirus gastroenteritis at 2,787. The estimated annual incidence of foodborne salmonellosis, shigellosis and norovirus gastroenteritis were 242, 36, and 567 cases per 100,000 population, respectively, which substantially exceeded the incidence of reported foodborne disease. CONCLUSIONS: We concluded that AGE and foodborne gastroenteritis caused by non-typhoidal S. enterica, Shigella and norovirus constitute a significant health burden in Gansu Province. By continuously implementing population survey and enhanced sentinel hospital surveillance, with constructing a multiplier calculation model to estimate the burden of disease, we may gain a better understanding of the food safety situation in Northwest China.