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Melioidosis in the Philippines.

Peter Franz M San Martin1, Joseph C Chua2, Ralph Louie P Bautista3

  • 1Department of Physiology, College of Medicine, University of the East-Ramon Magsaysay Memorial Medical Center Inc., Aurora Boulevard, Quezon City 1113, Philippines. petersanmartinmd@gmail.com.

Tropical Medicine and Infectious Disease
|October 3, 2018
PubMed
Summary

Melioidosis is underreported in the Philippines, with diabetes mellitus a common comorbidity. This review highlights challenges in defining the true burden of this serious bacterial infection.

Keywords:
Burkholderia pseudomalleiPhilippinesmelioidosis

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Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is endemic in Southeast Asia.
  • Sporadic cases and traveler-associated diagnoses of melioidosis in the Philippines have been reported since 1948.
  • Indigenous cases are rarely documented, suggesting significant under-reporting.

Purpose of the Study:

  • To collate and review all documented and unpublished cases of melioidosis in the Philippines.
  • To assess the epidemiology, clinical presentation, treatment, and outcomes of melioidosis in the country.
  • To identify challenges in understanding the true burden of melioidosis in the Philippines.

Main Methods:

  • Systematic review of international and local literature.
  • Inclusion of unpublished case series and reports from Philippine tertiary hospitals.
  • Data extraction on case demographics, comorbidities, clinical presentation, treatment, and outcomes.

Main Results:

  • A total of 41 cases were identified from 25 papers, including 23 indigenous cases (20 previously unreported).
  • Diabetes mellitus was the most common comorbidity; pulmonary and soft tissue infections were the most frequent presentations.
  • Ceftazidime was the primary intensive phase treatment, followed by trimethoprim-sulfamethoxazole for eradication. Mortality was 14.6%, with a 4.9% recurrence rate.

Conclusions:

  • The true burden of melioidosis in the Philippines remains undefined due to under-reporting.
  • Key challenges include lack of clinician awareness, inadequate laboratory facilities, and absence of a national surveillance system.
  • Enhanced surveillance and diagnostic capacity are crucial for accurate assessment and management of melioidosis in the Philippines.