Tropical Medicine and Infectious Disease (Apr 2018)

Melioidosis in Thailand: Present and Future

  • Soawapak Hinjoy,
  • Viriya Hantrakun,
  • Somkid Kongyu,
  • Jedsada Kaewrakmuk,
  • Tri Wangrangsimakul,
  • Siroj Jitsuronk,
  • Weerawut Saengchun,
  • Saithip Bhengsri,
  • Thantapat Akarachotpong,
  • Somsak Thamthitiwat,
  • Ornuma Sangwichian,
  • Siriluck Anunnatsiri,
  • Rasana W Sermswan,
  • Ganjana Lertmemongkolchai,
  • Chayada Sitthidet Tharinjaroen,
  • Kanya Preechasuth,
  • Ratchadaporn Udpaun,
  • Poomin Chuensombut,
  • Nisarat Waranyasirikul,
  • Chanihcha Anudit,
  • Surapong Narenpitak,
  • Yaowaruk Jutrakul,
  • Prapit Teparrukkul,
  • Nittaya Teerawattanasook,
  • Kittisak Thanvisej,
  • Alisa Suphan,
  • Punchawee Sukbut,
  • Kritchavat Ploddi,
  • Poolsri Sirichotirat,
  • Bongkoch Chiewchanyon,
  • Kamolchanok Rukseree,
  • Maliwan Hongsuwan,
  • Gumphol Wongsuwan,
  • Pornpan Sunthornsut,
  • Vanaporn Wuthiekanun,
  • Sandy Sachaphimukh,
  • Prapass Wannapinij,
  • Wirongrong Chierakul,
  • Claire Chewapreecha,
  • Janjira Thaipadungpanit,
  • Narisara Chantratita,
  • Sunee Korbsrisate,
  • Apichai Taunyok,
  • Susanna Dunachie,
  • Prasit Palittapongarnpim,
  • Stitaya Sirisinha,
  • Rungrueng Kitphati,
  • Sopon Iamsirithaworn,
  • Wipada Chaowagul,
  • Ploenchan Chetchotisak,
  • Toni Whistler,
  • Surasakdi Wongratanacheewin,
  • Direk Limmathurotsakul

DOI
https://doi.org/10.3390/tropicalmed3020038
Journal volume & issue
Vol. 3, no. 2
p. 38

Abstract

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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.

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