Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologies

Introduction Sustaining declines in global infectious disease burden will increasingly require efforts targeted to specific aetiological agents and common transmission pathways, particularly in this era of global change and human interconnectivity accelerating transmission and emergence of infectiou...

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Main Authors: Margaret N Kosek, Brecht Devleesschauwer, Shannon E Majowicz, Josh M Colston, Thomas G Flynn, Andrea H Denton, Francesca Schiaffino, Carlotta Di Bari, Yuki Minato
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/4/e093018.full
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author Margaret N Kosek
Brecht Devleesschauwer
Shannon E Majowicz
Josh M Colston
Thomas G Flynn
Andrea H Denton
Francesca Schiaffino
Carlotta Di Bari
Yuki Minato
author_facet Margaret N Kosek
Brecht Devleesschauwer
Shannon E Majowicz
Josh M Colston
Thomas G Flynn
Andrea H Denton
Francesca Schiaffino
Carlotta Di Bari
Yuki Minato
author_sort Margaret N Kosek
collection DOAJ
description Introduction Sustaining declines in global infectious disease burden will increasingly require efforts targeted to specific aetiological agents and common transmission pathways, particularly in this era of global change and human interconnectivity accelerating transmission and emergence of infectious pathogens. Systematic reviews and meta-analyses can be an effective and resource-efficient method for synthesising evidence regarding disease epidemiology for a wide range of pathogens and are the evidence source used by initiatives like the Planetary Child Health and Enterics Observatory (Plan-EO) and the WHO to determine the aetiology-specific epidemiology of diarrhoeal disease. Therefore, we developed this integrated systematic review methodology and protocol that aims to compile a database of published prevalence estimates for 17 diarrhoea-causing pathogens as inputs for disease burden estimation.Methods and analysis We will seek estimates of the prevalence of each endemic enteric pathogen estimated from published population-based studies that diagnosed their presence in stool samples from both asymptomatic subjects and those experiencing diarrhoea. The pathogens include the enteric viruses adenovirus, astrovirus, norovirus, rotavirus and sapovirus, the bacteria Campylobacter, Shigella, Salmonella enterica, Vibrio cholerae and the Escherichia coli (E. coli) pathotypes enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli and Shiga-toxin-producing E. coli and the intestinal protozoa Cryptosporidium, Cyclospora, Entamoeba histolytica and Giardia. Meta-analytical methods for analyses of the resulting database (including risk of bias analysis) will be published alongside their findings.Ethics and dissemination This systematic review is exempt from ethics approval because the work is carried out on published documents. The database that results from this review will be made available as a supplementary file of the resulting published manuscript. It will also be made available for download from the Plan-EO website, where updated versions will be posted on a quarterly basis.PROSPERO registration number CRD42023427998.
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spelling doaj-art-a44acbed3fe04487a8c088e3f468da962025-08-20T01:51:42ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-093018Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologiesMargaret N Kosek0Brecht Devleesschauwer1Shannon E Majowicz2Josh M Colston3Thomas G Flynn4Andrea H Denton5Francesca Schiaffino6Carlotta Di Bari7Yuki Minato81 Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA5 Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium4 School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada1 Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA1 Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA2 Claude Moore Health Sciences Library, University of Virginia, Charlottesville, Virginia, USA1 Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA5 Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium7 Department of Nutrition and Food Safety, World Health Organization, Geneva, SwitzerlandIntroduction Sustaining declines in global infectious disease burden will increasingly require efforts targeted to specific aetiological agents and common transmission pathways, particularly in this era of global change and human interconnectivity accelerating transmission and emergence of infectious pathogens. Systematic reviews and meta-analyses can be an effective and resource-efficient method for synthesising evidence regarding disease epidemiology for a wide range of pathogens and are the evidence source used by initiatives like the Planetary Child Health and Enterics Observatory (Plan-EO) and the WHO to determine the aetiology-specific epidemiology of diarrhoeal disease. Therefore, we developed this integrated systematic review methodology and protocol that aims to compile a database of published prevalence estimates for 17 diarrhoea-causing pathogens as inputs for disease burden estimation.Methods and analysis We will seek estimates of the prevalence of each endemic enteric pathogen estimated from published population-based studies that diagnosed their presence in stool samples from both asymptomatic subjects and those experiencing diarrhoea. The pathogens include the enteric viruses adenovirus, astrovirus, norovirus, rotavirus and sapovirus, the bacteria Campylobacter, Shigella, Salmonella enterica, Vibrio cholerae and the Escherichia coli (E. coli) pathotypes enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli and Shiga-toxin-producing E. coli and the intestinal protozoa Cryptosporidium, Cyclospora, Entamoeba histolytica and Giardia. Meta-analytical methods for analyses of the resulting database (including risk of bias analysis) will be published alongside their findings.Ethics and dissemination This systematic review is exempt from ethics approval because the work is carried out on published documents. The database that results from this review will be made available as a supplementary file of the resulting published manuscript. It will also be made available for download from the Plan-EO website, where updated versions will be posted on a quarterly basis.PROSPERO registration number CRD42023427998.https://bmjopen.bmj.com/content/15/4/e093018.full
spellingShingle Margaret N Kosek
Brecht Devleesschauwer
Shannon E Majowicz
Josh M Colston
Thomas G Flynn
Andrea H Denton
Francesca Schiaffino
Carlotta Di Bari
Yuki Minato
Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologies
BMJ Open
title Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologies
title_full Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologies
title_fullStr Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologies
title_full_unstemmed Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologies
title_short Updating global estimates of pathogen-attributable diarrhoeal disease burden: a methodology and integrated protocol for a broad-scope systematic review of a syndrome with diverse infectious aetiologies
title_sort updating global estimates of pathogen attributable diarrhoeal disease burden a methodology and integrated protocol for a broad scope systematic review of a syndrome with diverse infectious aetiologies
url https://bmjopen.bmj.com/content/15/4/e093018.full
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