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Global burden of melioidosis in 2015: a systematic review and data synthesis

Emma Birnie1, Harjeet S Virk1, Jelmer Savelkoel1

  • 1Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Amsterdam Infection & Immunity Institute, University of Amsterdam, Amsterdam, Netherlands.

The Lancet. Infectious Diseases
|July 10, 2019
PubMed
Abstract

Insights

Melioidosis, a fatal bacterial infection, caused a global burden of 4.6 million disability-adjusted life-years (DALYs) in 2015. This significant impact warrants its reconsideration as a major neglected tropical disease.

Area of Science:

  • Infectious Diseases
  • Global Health Epidemiology
  • Bacteriology

Background:

  • Melioidosis is a severe infectious disease caused by Burkholderia pseudomallei, prevalent in tropical regions.
  • The clinical spectrum of melioidosis is broad, ranging from localized abscesses to life-threatening pneumonia and sepsis.
  • High fatality rates underscore the urgent need to understand its global impact.

Purpose of the Study:

  • To assess the global burden of melioidosis in 2015, quantified using disability-adjusted life-years (DALYs).
  • To provide a comprehensive epidemiological overview of melioidosis cases and outcomes.
  • To inform public health strategies and resource allocation for neglected tropical diseases.

Main Methods:

  • A systematic review of peer-reviewed literature from 1990 to 2015 identified human melioidosis cases.
  • Quantitative data on mortality, demographics, clinical sequelae, and treatment were extracted.
  • An incidence-based disease model integrated extracted data with global estimates to calculate DALYs.

Main Results:

  • The global burden of melioidosis in 2015 was estimated at 4.6 million DALYs (84.3 DALYs per 100,000 population).
  • Pneumonia, intra-abdominal abscess, and sepsis were the most frequent clinical presentations.
  • Years of life lost constituted 98.9% of the total DALYs, highlighting the disease's impact on premature mortality.

Conclusions:

  • Melioidosis imposes a substantial disease burden, comparable to or exceeding that of recognized neglected tropical diseases.
  • The findings support the reclassification of melioidosis as a major neglected tropical disease.
  • Further research and targeted interventions are crucial to mitigate the impact of this often-fatal infection.

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