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Melioidosis in Sri Lanka

Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
Faculty of Medicine, Kotelawala Defence University, Ratmalana 10390, Sri Lanka
Faculty of Medicine, University of Peradeniya, Peradeniya 2000, Sri Lanka
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2018, 3(1), 22;
Received: 31 January 2018 / Revised: 16 February 2018 / Accepted: 16 February 2018 / Published: 21 February 2018
(This article belongs to the Special Issue Global Burden and Challenges of Melioidosis)
Until recently, Sri Lanka was not considered a country with endemic melioidosis. However, an increasing number of cases is being reported. National surveillance for melioidosis was instituted after 2008. A total of 250 culture-positive cases was recorded between 2006 and May 2017. Males predominated (71.6%). The age range was wide (2–92 years) reflecting a ubiquity of exposure. The majority (201/250, 80%) lived in rural areas. All provinces were affected. Case load increased during the two monsoonal periods (67%). There was representation of every population group including farmers (n = 44), housewives (n = 24), school children (n = 10), professionals (n = 5), businesspersons (n = 6), white-collar workers (n = 10) and blue-collar workers (n = 8). Diabetes was the predominant risk factor (n = 163, 65.2%). Clinical presentations included community-acquired sepsis and pneumonia, superficial and deep abscesses, and septic arthritis. Mortality was 20.4% (51/250). A majority (n = 212) of isolates belonged to the YLF (Yersinia-like fimbrial) clade but 38 were BTFC (B. thailandensis-like flagellum and chemotaxis). A total of 108 isolates was genotyped and 46 sequence types (STs) were identified, 40 being novel. It is clear that melioidosis is endemic in Sri Lanka with a wide geographic and demographic distribution. There is an urgent need to extend surveillance of melioidosis to under-resourced parts of the country and to populations at high risk. View Full-Text
Keywords: melioidosis; Sri Lanka; epidemiology; Burkholderia pseudomallei melioidosis; Sri Lanka; epidemiology; Burkholderia pseudomallei
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Corea, E.M.; De Silva, A.D.; Thevanesam, V. Melioidosis in Sri Lanka. Trop. Med. Infect. Dis. 2018, 3, 22.

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