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Trop. Med. Infect. Dis. 2018, 3(2), 38; https://doi.org/10.3390/tropicalmed3020038

Melioidosis in Thailand: Present and Future

1
Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
2
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
3
Faculty of Science, Prince of Songkla University, Songkla 90110, Thailand
4
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
5
Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand
6
Department of Clinical Pathology, Chiang Rai Prachanukroh Hospital, Chiang Rai 57000, Thailand
7
Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand
8
Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
9
The Centre for Research & Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
10
Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
11
Department of Clinical Pathology, Chiangkham Hospital, Phayao, 56110 Thailand
12
Department of Clinical Pathology, Somdejphrajaotaksin Maharaj Hospital, Tak 63000, Thailand
13
Department of Clinical Pathology, Uthai Thani Hospital, Uthai Thani 61000, Thailand
14
Department of Internal Medicine, Udon Thani Hospital, Udon Thani 41000, Thailand
15
Department of Clinical Pathology, Udon Thani Hospital, Udon Thani 41000, Thailand
16
Department of Internal Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand
17
Department of Clinical Pathology, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand
18
Department of Internal Medicine, Nakhon Panom Hospital, Nakhon Panom 48000, Thailand
19
Ubon Ratchathani Provincial Public Health Office, Ubon Ratchathani 34000, Thailand
20
Mukdahan Provincial Public Health Office, Mukdahan 49000, Thailand
21
The Office of Disease Prevention and Control 8, Udon Thani 41000, Thailand
22
The Office of Disease Prevention and Control 10, Ubon Ratchathani 34000, Thailand
23
The Office of Disease Prevention and Control 12, Songkla 90000, Thailand
24
Mahidol University Amnatcharoen Campus, Amnatcharoen 37000, Thailand
25
Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
26
Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
27
Department of Infectious Diseases & Immunology, Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA
28
National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand
29
Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
30
Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok 10220, Thailand
31
Bureau of General Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
*
Author to whom correspondence should be addressed.
Received: 31 January 2018 / Revised: 13 March 2018 / Accepted: 21 March 2018 / Published: 8 April 2018
(This article belongs to the Special Issue Global Burden and Challenges of Melioidosis)
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Abstract

A recent modelling study estimated that there are 2800 deaths due to melioidosis in Thailand yearly. The Thailand Melioidosis Network (formed in 2012) has been working closely with the Ministry of Public Health (MoPH) to investigate and reduce the burden of this disease. Based on updated data, the incidence of melioidosis is still high in Northeast Thailand. More than 2000 culture-confirmed cases of melioidosis are diagnosed in general hospitals with microbiology laboratories in this region each year. The mortality rate is around 35%. Melioidosis is endemic throughout Thailand, but it is still not uncommon that microbiological facilities misidentify Burkholderia pseudomallei as a contaminant or another organism. Disease awareness is low, and people in rural areas neither wear boots nor boil water before drinking to protect themselves from acquiring B. pseudomallei. Previously, about 10 melioidosis deaths were formally reported to the National Notifiable Disease Surveillance System (Report 506) each year, thus limiting priority setting by the MoPH. In 2015, the formally reported number of melioidosis deaths rose to 112, solely because Sunpasithiprasong Hospital, Ubon Ratchathani province, reported its own data (n = 107). Melioidosis is truly an important cause of death in Thailand, and currently reported cases (Report 506) and cases diagnosed at research centers reflect the tip of the iceberg. Laboratory training and communication between clinicians and laboratory personnel are required to improve diagnosis and treatment of melioidosis countrywide. Implementation of rapid diagnostic tests, such as a lateral flow antigen detection assay, with high accuracy even in melioidosis-endemic countries such as Thailand, is critically needed. Reporting of all culture-confirmed melioidosis cases from every hospital with a microbiology laboratory, together with final outcome data, is mandated under the Communicable Diseases Act B.E.2558. By enforcing this legislation, the MoPH could raise the priority of this disease, and should consider implementing a campaign to raise awareness and melioidosis prevention countrywide. View Full-Text
Keywords: Burkholderia pseudomallei; melioidosis; Thailand; mortality; diagnosis; surveillance; awareness; treatment; prevention Burkholderia pseudomallei; melioidosis; Thailand; mortality; diagnosis; surveillance; awareness; treatment; prevention
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Hinjoy, S.; Hantrakun, V.; Kongyu, S.; Kaewrakmuk, J.; Wangrangsimakul, T.; Jitsuronk, S.; Saengchun, W.; Bhengsri, S.; Akarachotpong, T.; Thamthitiwat, S.; Sangwichian, O.; Anunnatsiri, S.; Sermswan, R.W.; Lertmemongkolchai, G.; Sitthidet Tharinjaroen, C.; Preechasuth, K.; Udpaun, R.; Chuensombut, P.; Waranyasirikul, N.; Anudit, C.; Narenpitak, S.; Jutrakul, Y.; Teparrukkul, P.; Teerawattanasook, N.; Thanvisej, K.; Suphan, A.; Sukbut, P.; Ploddi, K.; Sirichotirat, P.; Chiewchanyon, B.; Rukseree, K.; Hongsuwan, M.; Wongsuwan, G.; Sunthornsut, P.; Wuthiekanun, V.; Sachaphimukh, S.; Wannapinij, P.; Chierakul, W.; Chewapreecha, C.; Thaipadungpanit, J.; Chantratita, N.; Korbsrisate, S.; Taunyok, A.; Dunachie, S.; Palittapongarnpim, P.; Sirisinha, S.; Kitphati, R.; Iamsirithaworn, S.; Chaowagul, W.; Chetchotisak, P.; Whistler, T.; Wongratanacheewin, S.; Limmathurotsakul, D. Melioidosis in Thailand: Present and Future. Trop. Med. Infect. Dis. 2018, 3, 38.

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