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Melioidosis in Sri Lanka.
Enoka M Corea1, Aruna Dharshan de Silva2, Vasanthi Thevanesam3
1Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka. enokac@micro.cmb.ac.lk.
Tropical Medicine and Infectious Disease
|October 3, 2018
Summary
Melioidosis is now endemic in Sri Lanka, with increasing cases reported nationwide since 2008. Enhanced surveillance is crucial, especially in rural areas and among high-risk populations like diabetics.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Sri Lanka was not previously considered endemic for melioidosis.
- An increasing number of melioidosis cases have been reported recently.
- National surveillance for melioidosis was established in 2008.
Purpose of the Study:
- To describe the epidemiology and clinical characteristics of melioidosis in Sri Lanka.
- To identify risk factors and prevalent bacterial clades.
- To highlight the need for expanded surveillance.
Main Methods:
- Analysis of 250 culture-positive melioidosis cases from 2006 to May 2017.
- Data collection on patient demographics, geographic distribution, seasonality, risk factors, and clinical presentations.
- Genotyping of bacterial isolates to identify sequence types (STs) and clades (YLF and BTFC).
Main Results:
- A total of 250 cases were recorded, predominantly affecting males (71.6%) across all age groups and provinces.
- Most cases (80%) were from rural areas, with a peak during monsoonal periods (67%).
- Diabetes was the main risk factor (65.2%), and mortality was 20.4%. Genotyping revealed 46 sequence types, with 40 being novel.
Conclusions:
- Melioidosis is clearly endemic in Sri Lanka, exhibiting wide geographic and demographic distribution.
- The study underscores the significant public health burden of melioidosis in the country.
- There is an urgent need to extend melioidosis surveillance to under-resourced areas and high-risk populations.
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