Melioidosis in India and Bangladesh: A review of case reports
Journal Title: Asian Pacific Journal of Tropical Medicine - Year 2018, Vol 11, Issue 5
Abstract
Objective: To conduct an epidemiological and clinical review of published case reports of melioidosis from India and Bangladesh. Methods: Data from published case reports were abstracted and summarized. We further compared the clinical epidemiology of the melioidosis cases in India with case series from highly endemic areas in Northern Australia and Southeast Asia to elucidate any differences in presentations and risk factors between the regions. Results: We identified a total of 99 cases published between 1953 and June 2016, originating from India (n=85) or Bangladesh (n=14). Cases were predominantly male and ranged in age from 1 month to 90 years. Diabetes mellitus was the most common risk factor reported (58%). About 28% of the cases had history of exposure via high-risk occupations or exposure to contaminated water. The overall case fatality rate (CFR) was 26%. Factors influencing mortality included the occurrence of septic shock (CFR, 80%), environmental exposure (CFR, 39%), primary presentation of pneumonia (CFR, 38%), misdiagnosed and/or mistreated cases (CFR, 33%) or the presence of a risk factor (CFR, 29%). Because of the small number of cases in Bangladesh, pattern of clinical epidemiology is limited to India. Soft tissue abscess (37%) was the most common clinical presentation reported from India followed by pneumonia (24%) and osteomyelitis/septic arthritis (18%). Neurological melioidosis (n=10, 12%) presented as pyemic lesions of the brain or meninges. A few cases of prostatic abscess (n=4) in men and parotid abscess (n=4) were also noted. The above patterns were consistent with case series from Southeast Asia and Northern Australia for the most part, in terms of risk factors associated with infection and factors influencing mortality. Differences included clinical presentation of pneumonia which was notably lower than that reported in Southeast Asia and Northern Australia; a higher proportion of neurological and parotid abscess presentation; and a lower CFR compared to that reported in case series in Southeast Asia. About 39% of the cases were misdiagnosed and/or mistreated, suggesting underreporting and under estimation of the true disease burden. Conclusions: The concentration of melioidosis cases in southern and eastern states in India and in Bangladesh, which share climatic conditions and rice farming activities with known endemic areas in Southeast Asia, suggests an endemicity of melioidosis in this region. Thus, increased awareness among healthcare personnel, particularly among clinicians and nurses practicing in rural areas, and improved surveillance through case registries is essential to guide early diagnosis and prompt treatment.
Authors and Affiliations
Meghan Tipre
Keywords
Related Articles
- EP ID EP294637
- DOI 10.4103/1995-7645.233179
- Views 67
- Downloads 0
Health situation and challenges in Sri Lanka
Sri Lanka, an island in the Indian Ocean, is 65 610km2 with a population of 21 million (population density 315/km2). It is a low-middle income country with GDP per capita of USD 4 310. However, due to policies of free ed...
Distribution and ecological aspects of sand flies (Diptera: Psychodidae) species in Northeastern Iran
Objective: To determine both the distribution and the ecological characteristics of sand flies in Golestan Province, northeast of Iran in 2016. Methods: In this study, 34 villages were selected based on their geographica...
Phytochemical analysis and antioxidant profile of methanolic extract of seed, pulp and peel of Baccaurea ramiflora Lour.
Objective: To analyze the phytochemical constituents responsible for the plausible antioxidant effect of methanolic extract of the seed, pulp and peel of Baccaurea ramiflora Lour. Methods: Fresh seed, pulp, and peel of B...
High glucose induces myocardial cell injury through increasing reactive oxygen species production
Objective: To study the injury effect and molecular mechanism of high glucose on myocardial cells. Methods: Myocardial cells H9c2 were cultured and divided into the control group treated with DMEM containing 5.5 mmol/L g...
First report on molecular characterization of Leishmania species from cutaneous leishmaniasis patients in southern Khyber Pakhtunkhwa province of Pakistan
Objective: To report presence of Leishmania major in Khyber Pakhtunkhwa of Pakistan, where cutaneous leishmaniasis (CL) is endemic and was thought to be caused by Leishmania tropica only. Methods: Biopsy samples from 432...