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dc.contributor.authorDirek Limmathurotsakulen_US
dc.contributor.authorManas Kanoksilen_US
dc.contributor.authorVanaporn Wuthiekanunen_US
dc.contributor.authorRungrueng Kitphatien_US
dc.contributor.authorBianca deStavolaen_US
dc.contributor.authorNicholas P.J. Dayen_US
dc.contributor.authorSharon J. Peacocken_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherSappasitthiprasong Hospitalen_US
dc.contributor.otherThailand Ministry of Public Healthen_US
dc.contributor.otherLondon School of Hygiene & Tropical Medicineen_US
dc.contributor.otherNuffield Department of Clinical Medicineen_US
dc.contributor.otherUniversity of Cambridgeen_US
dc.date.accessioned2018-10-19T05:40:01Z-
dc.date.available2018-10-19T05:40:01Z-
dc.date.issued2013-01-01en_US
dc.identifier.citationPLoS Neglected Tropical Diseases. Vol.7, No.2 (2013)en_US
dc.identifier.issn19352735en_US
dc.identifier.issn19352727en_US
dc.identifier.other2-s2.0-84874784570en_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84874784570&origin=inwarden_US
dc.identifier.urihttp://repository.li.mahidol.ac.th/dspace/handle/123456789/32695-
dc.description.abstractBackground: Melioidosis is a serious infectious disease caused by the Category B select agent and environmental saprophyte, Burkholderia pseudomallei. Most cases of naturally acquired infection are assumed to result from skin inoculation after exposure to soil or water. The aim of this study was to provide evidence for inoculation, inhalation and ingestion as routes of infection, and develop preventive guidelines based on this evidence. Methods/Principal Findings: A prospective hospital-based 1:2 matched case-control study was conducted in Northeast Thailand. Cases were patients with culture-confirmed melioidosis, and controls were patients admitted with non-infectious conditions during the same period, matched for gender, age, and diabetes mellitus. Activities of daily living were recorded for the 30-day period before onset of symptoms, and home visits were performed to obtain drinking water and culture this for B. pseudomallei. Multivariable conditional logistic regression analysis based on 286 cases and 512 controls showed that activities associated with a risk of melioidosis included working in a rice field (conditional odds ratio [cOR] = 2.1; 95% confidence interval [CI] 1.4-3.3), other activities associated with exposure to soil or water (cOR = 1.4; 95%CI 0.8-2.6), an open wound (cOR = 2.0; 95%CI 1.2-3.3), eating food contaminated with soil or dust (cOR = 1.5; 95%CI 1.0-2.2), drinking untreated water (cOR = 1.7; 95%CI 1.1-2.6), outdoor exposure to rain (cOR = 2.1; 95%CI 1.4-3.2), water inhalation (cOR = 2.4; 95%CI 1.5-3.9), current smoking (cOR = 1.5; 95%CI 1.0-2.3) and steroid intake (cOR = 3.1; 95%CI 1.4-6.9). B. pseudomallei was detected in water source(s) consumed by 7% of cases and 3% of controls (cOR = 2.2; 95%CI 0.8-5.8). Conclusions/Significance: We used these findings to develop the first evidence-based guidelines for the prevention of melioidosis. These are suitable for people in melioidosis-endemic areas, travelers and military personnel. Public health campaigns based on our recommendations are under development in Thailand. © 2013 Limmathurotsakul et al.en_US
dc.rightsMahidol Universityen_US
dc.source.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84874784570&origin=inwarden_US
dc.subjectMedicineen_US
dc.titleActivities of Daily Living Associated with Acquisition of Melioidosis in Northeast Thailand: A Matched Case-Control Studyen_US
dc.typeArticleen_US
dc.rights.holderSCOPUSen_US
dc.identifier.doi10.1371/journal.pntd.0002072en_US
Appears in Collections:Scopus 2011-2015

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