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Trop. Med. Infect. Dis. 2018, 3(1), 25; https://doi.org/10.3390/tropicalmed3010025

Melioidosis in Malaysia: Incidence, Clinical Challenges, and Advances in Understanding Pathogenesis

1
School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
2
Emergency Department, Pantai Hospital Ipoh, 31400 Ipoh, Malaysia
3
Department of Paediatrics, Bintulu Hospital, Bintulu 97000, Malaysia
4
Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan 94300, Malaysia
5
Department of Paediatrics, Sarawak General Hospital, Kuching 93586, Malaysia
6
Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
7
Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
8
Department of Internal Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan 25200, Malaysia
*
Authors to whom correspondence should be addressed.
Received: 9 January 2018 / Revised: 18 February 2018 / Accepted: 18 February 2018 / Published: 27 February 2018
(This article belongs to the Special Issue Global Burden and Challenges of Melioidosis)
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Abstract

Malaysia is an endemic hot spot for melioidosis; however, a comprehensive picture of the burden of disease, clinical presentations, and challenges faced in diagnosis and treatment of melioidosis is not available. This review provides a nonexhaustive overview of epidemiological data, clinical studies, risk factors, and mortality rates from available literature and case reports. Clinical patterns of melioidosis are generally consistent with those from South and Southeast Asia in terms of common primary presentations with diabetes as a major risk factor. Early diagnosis and appropriate management of Malaysian patients is a key limiting factor, which needs to be addressed to reduce serious complications and high mortality and recurrence rates. Promoting awareness among the local healthcare personnel is crucial to improving diagnostics and early treatment, as well as educating the Malaysian public on disease symptoms and risk factors. A further matter of urgency is the need to make this a notifiable disease and the establishment of a national melioidosis registry. We also highlight local studies on the causative agent, Burkholderia pseudomallei, with regards to bacteriology and identification of virulence factors as well as findings from host–pathogen interaction studies. Collectively, these studies have uncovered new correlations and insights for further understanding of the disease. View Full-Text
Keywords: melioidosis; Burkholderia pseudomallei; Malaysia; epidemiology; bacteriology melioidosis; Burkholderia pseudomallei; Malaysia; epidemiology; bacteriology
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Nathan, S.; Chieng, S.; Kingsley, P.V.; Mohan, A.; Podin, Y.; Ooi, M.-H.; Mariappan, V.; Vellasamy, K.M.; Vadivelu, J.; Daim, S.; How, S.-H. Melioidosis in Malaysia: Incidence, Clinical Challenges, and Advances in Understanding Pathogenesis. Trop. Med. Infect. Dis. 2018, 3, 25.

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