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Melioidosis in the Lao People's Democratic Republic
David A B Dance1,2,3, Manophab Luangraj4, Sayaphet Rattanavong5
1Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos. david.d@tropmedres.ac.
Abstract:
Melioidosis is clearly highly endemic in Laos, although the disease has only been diagnosed regularly in humans (1359 cases) since 1999, and only a single animal case has been microbiologically confirmed. Burkholderia pseudomallei is extensively and abundantly present in soil and surface water in central and southern Laos, but the true distribution of the disease across the country remains to be determined. Surveillance is almost non-existent and diagnostic microbiology services are not yet well established, whilst awareness of melioidosis is low amongst policy-makers, healthcare providers, and the public. It is hoped that this situation will improve over the next decade as the country rapidly develops, especially as this is likely to be accompanied by a further increase in the prevalence of diabetes, meaning that more people in this predominantly agricultural population will be at risk of contracting melioidosis.
Insights
Melioidosis is highly endemic in Laos, with Burkholderia pseudomallei abundant in soil and water. Improved surveillance and awareness are crucial as diabetes prevalence rises, increasing population risk.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Melioidosis is a significant public health concern in Laos, with a notable increase in human cases since 1999.
- The causative agent, Burkholderia pseudomallei, is widespread in the environment, particularly in soil and water in central and southern regions.
- Limited surveillance and diagnostic capabilities, coupled with low public and professional awareness, hinder effective disease control.
Purpose of the Study:
- To highlight the endemic nature of melioidosis in Laos.
- To underscore the environmental prevalence of Burkholderia pseudomallei.
- To emphasize the need for improved public health infrastructure and awareness regarding melioidosis.
Main Methods:
- Review of existing human case data since 1999.
- Assessment of Burkholderia pseudomallei environmental distribution.
- Analysis of current surveillance, diagnostic, and awareness levels.
Main Results:
- Over 1359 human melioidosis cases diagnosed since 1999.
- Extensive presence of Burkholderia pseudomallei confirmed in soil and surface water.
- Current surveillance and diagnostic services are underdeveloped, and awareness is low.
Conclusions:
- Melioidosis is highly endemic in Laos, posing a substantial threat.
- Environmental contamination with Burkholderia pseudomallei is widespread.
- Future development in Laos may increase diabetes prevalence, elevating the risk for the agricultural population and necessitating enhanced melioidosis prevention and control strategies.