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Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis
Published on: February 24, 2023
Pahang melioidosis registry
S H How1, T H Ng, A R Jamalludin
1Kulliyyah of Medicine, International Islamic University Malaysia, P.O. Box 141, 27510, Kuantan, Pahang, Malaysia. how_sh@yahoo.com
Abstract:
Melioidosis has a high annual incidence and mortality rate in Pahang, Malaysia. We initiated the first melioidosis registry in the country on 1st July 2005 to improve the management of melioidosis in the state. Continuous medical education on melioidosis was carried out in all hospitals in the state to highlight the magnitude of the disease and to educate the doctors on the treatment of the disease. All culture confirmed cases were registered and analysed. During the one-year study period from 1st July 2005 till 30th June 2006, a total of 63 patients had positive culture for Burkholderia pseudomallei. The calculated annual incidence of melioidosis in Pahang state was 4.3 per 100,000 population per year (Adult, 6.0 per 100, 000 population per year and paediatric, 1.6 per 100,000 population per year). There were 55 Malays (87.3%), three Chinese (4.8%), four aborigines (6.3%) and one Indonesian. Nine (14.3%) were less than 18 years old. The median age was 49 years (range: 1-68 years). Only one patient (1.6%) had a previous history of confirmed melioidosis. With this programme, we had observed a decline in adult mortality from 54% to 44%, although this was not statistically significant. However, culture-confirmed relapses had dropped from 19% to nil. Several measures need to be taken to decrease mortality from melioidosis in endemic countries.
Insights
Establishing Malaysia's first melioidosis registry and enhancing medical education reduced disease relapses significantly. While adult mortality saw a slight decline, further measures are needed to decrease melioidosis deaths in endemic regions.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Melioidosis, caused by Burkholderia pseudomallei, presents a significant public health challenge in Pahang, Malaysia, with high incidence and mortality rates.
- Effective management strategies are crucial to mitigate the impact of this zoonotic disease in endemic areas.
Purpose of the Study:
- To establish the first melioidosis registry in Malaysia to improve disease management in Pahang.
- To assess the impact of a comprehensive melioidosis control program, including continuous medical education and case registration, on disease outcomes.
Main Methods:
- Initiation of a state-wide melioidosis registry on July 1, 2005.
- Implementation of continuous medical education for healthcare professionals across all hospitals in Pahang.
- Analysis of culture-confirmed Burkholderia pseudomallei cases registered over a one-year period (July 1, 2005 - June 30, 2006).
Main Results:
- The calculated annual incidence of melioidosis in Pahang was 4.3 per 100,000 population.
- A total of 63 culture-confirmed cases were registered, with the majority being Malay (87.3%).
- Observed a reduction in adult melioidosis mortality from 54% to 44% and a complete elimination of culture-confirmed relapses (from 19% to 0%).
Conclusions:
- The melioidosis registry and enhanced medical education program showed a positive impact, particularly in reducing disease relapses.
- While a decline in mortality was observed, it was not statistically significant, indicating a need for further interventions.
- Continued efforts and strategic measures are essential to further decrease melioidosis mortality in endemic countries like Malaysia.
