National studies on foodborne diseases are needed to help a country set its food safety priorities, according to researchers.

An international team said precise national estimates are essential to rank diseases and hazards in a country, as well as foods contributing the most and the interventions needed for effective prevention. Only when countries know what makes people sick are they able to target measures and allocate resources in areas where food safety risks are highest.

The current burden of disease landscape remains scattered, and researchers struggle to translate their findings to useable input for policy decision makers. Pre-COVID, many countries lacked political commitment, technical and financial resources, and data to estimate the burden of foodborne diseases, and scientists in the journal Current Opinion in Food Science anticipated these barriers will increase as a result of the pandemic.

Burden of foodborne disease studies form the basis for informed risk management decisions. Burden can be expressed using indicators such as incidence, mortality, societal costs, summary measures of population health and Disability-Adjusted Life Years (DALY).

Benefits of such studies
Promoting national burden of foodborne disease studies relies on factors including the usefulness of such estimates for risk ranking, priority setting and allocation of resources for food safety; harmonization of methodologies to compare estimates across diseases, countries and regions and novel technology to reduce the cost and help data collection, particularly in low-income and middle-income countries (LMIC).

In 2015, the World Health Organization (WHO) published the first estimates of the global and regional disease burden due to 31 foodborne hazards in 2010. This is in the process of being updated with new figures expected by 2025. The WHO is also working on a refreshed food safety strategy for publication in 2022.

Pilot national studies have been done in Albania, Japan, Thailand and Uganda. In Albania, the work fed into the reorganization of the national food safety system.

Two countries at the forefront of burden of foodborne disease estimation are the Netherlands and Denmark. A few other countries have set up such studies, publishing either routine figures or ad-hoc reports with estimates for specific pathogens and years.

Lack of data in Africa
The main challenge to estimating burden of foodborne disease in Africa is lack of data, particularly on incidence in the population. This limited availability is caused by factors such as the lack of capacity to generate, compile and analyze data; limited political commitment to strengthen surveillance systems; limited understanding of the benefits of burden of disease studies and a focus on selected notifiable priority diseases.

A project was launched in 2019 in Ethiopia, Mozambique, Nigeria, and Tanzania, to estimate the burden of, and strengthen surveillance systems for, foodborne diseases in Africa. Findings will improve accuracy of estimates in African contexts. Work involves analyzing human sewage samples using short-read next-generation sequencing (NGS).

The WHO is supporting nations to estimate the burden of foodborne diseases through technical assistance and developing guidance to assess the burden caused by microbiological agents at national level.

Researchers said the ground for promoting national burden of foodborne disease studies is being paved.

To take awareness of the usefulness of such studies to guide food safety interventions in the direction of actual implementation of studies will involve international organizations, local authorities and the scientific community, they added.

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