Abstract
Melioidosis is an often fatal infectious disease with a protean clinical spectrum, caused by the environmental bacterial pathogen Burkholderia pseudomallei. Although the disease has been reported from some African countries in the past, the present epidemiology of melioidosis in Africa is almost entirely unknown. Therefore, the common view that melioidosis is rare in Africa is not evidence-based. A recent study concludes that large parts of Africa are environmentally suitable for B. pseudomallei. Twenty-four African countries and three countries in the Middle East were predicted to be endemic, but no cases of melioidosis have been reported yet. In this study, we summarize the present fragmentary knowledge on human and animal melioidosis and environmental B. pseudomallei in Africa and the Middle East. We propose that systematic serological studies in man and animals together with environmental investigations on potential B. pseudomallei habitats are needed to identify risk areas for melioidosis. This information can subsequently be used to target raising clinical awareness and the implementation of simple laboratory algorithms for the isolation of B. pseudomallei from clinical specimens. B. pseudomallei was most likely transferred from Asia to the Americas via Africa, which is shown by phylogenetic analyses. More data on the virulence and genomic characteristics of African B. pseudomallei isolates will contribute to a better understanding of the global evolution of the pathogen and will also help to assess potential differences in disease prevalence and outcome.
Highlights
The global environmental distribution of B. pseudomallei and the world-wide incidence and mortality of meliodosis was estimated using a modelling approach
Metabolic characteristics of the isolate were different from the close relative Burkholderia mallei, indicating that the horse suffered from melioidosis but not glanders [4]
In 1961, a case of pulmonary melioidosis was described in southern Turkey, the information provided on the bacteriological identification procedure does not allow confirmation of B. pseudomallei with certainty [5]
Summary
The global environmental distribution of B. pseudomallei and the world-wide incidence and mortality of meliodosis was estimated using a modelling approach. The estimates suggest a massive underreporting in countries known to be endemic and identified 34 countries in which melioidosis is probably endemic and has never been reported Among those countries are 24 African countries and three countries in the Middle East. In some African and Middle East countries sporadic cases of human and animal melioidosis have been reported for many decades [2,3], sound epidemiological data for the disease do not exist for any of those countries. Peer-reviewed published cases of human and animal melioidosis together with reports on environmental B. pseudomallei in the various African sub-regions and the Middle East (sub-region Western Asia) were compiled based on journal research and by using the global occurrence database created by Limmathurotsakul et al [1]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
