Global Burden and Trends of Invasive Non-Typhoidal Salmonella Infection from 1990 to 2021

Abstract

Invasive non-typhoidal Salmonella (iNTS) infections pose a significant global health burden, yet comprehensive and up-to-date assessments of their worldwide impact remain limited. This study aimed to evaluate the global, regional, and national burden and trends of iNTS infections from 1990 to 2021. Data on the incidence and mortality of iNTS infections were obtained from the Global Burden of Disease (GBD) study 2021. Estimated annual percentage changes (EAPCs) were calculated to assess temporal trends, and the associations between iNTS burden and the Socio-demographic index (SDI) were analyzed. Globally, the number of iNTS incident cases increased by 46.44%, rising from 348, 244 in 1990 to 509, 976 in 2021. Mortality also rose by 26.72%, from 48, 941 deaths in 1990 to 62, 018 deaths in 2021. The global age-standardized incidence rate (ASIR) showed an overall increase (EAPC = 0.45), while the age-standardized mortality rate (ASMR) exhibited a modest annual rise of 0.2%. Significant regional disparities were observed, with Sub-Saharan Africa recording the highest ASIR and ASMR. A strong negative correlation was found between SDI and both ASIR and ASMR, although higher-SDI regions demonstrated a faster increase in ASIR. In conclusion, the global burden of iNTS infections has continued to rise over the past three decades, with notable regional inequalities. These findings highlight the urgent need for targeted interventions, improved diagnostic capacities, and strengthened surveillance of antimicrobial resistance.