Melioidosis in Mali: a retrospective observational study

Area of Science:

• Tropical medicine
• Bacteriology
• Public health epidemiology

Background:

• Melioidosis, caused by Burkholderia pseudomallei, is a neglected tropical bacterial infection with high mortality.
• Data on melioidosis burden and distribution in Africa are scarce, with previous reports from Mali being absent.
• This study addresses the knowledge gap by reporting melioidosis cases in young children in Mali.

Purpose of the Study:

• To report the first confirmed cases of melioidosis in children under 5 years old in Mali.
• To estimate the incidence of melioidosis in the pediatric and general population in the studied region.
• To underscore the public health significance of melioidosis in Africa.

Main Methods:

• Retrospective analysis of clinical data and bacterial isolates from children under 5 years old admitted to Médecins Sans Frontières in Koutiala, Mali (January 2018–September 2021).
• Biochemical characterization and whole genome sequencing of bacterial isolates to confirm Burkholderia pseudomallei.
• Analysis of clinical outcomes for confirmed melioidosis cases.

Main Results:

• Thirty-one cases of pediatric melioidosis were confirmed, with 48% occurring in infants under 12 months.
• The mortality rate among patients with available outcome data was high (63%).
• Estimated annual incidence rates were 8.8 per 100,000 for the pediatric population and 15.5 per 100,000 for the overall population, indicating significant disease burden.

Conclusions:

• This study presents the first case series of melioidosis in Mali and the largest cohort in Africa, revealing it as a significant public health issue.
• Findings emphasize the critical need for improved diagnostics, further research on African melioidosis burden, and integration into national health strategies.
• Addressing melioidosis is crucial for reducing high mortality rates, especially given its resistance to common antibiotics.