Publication: Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study
Accepted Date
2013-01-09
Issued Date
2013-02
Copyright Date
2013
Resource Type
Language
eng
ISSN
1935-2735 (electronic)
1935-2727 (printed)
1935-2727 (printed)
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Mahidol University
Rights Holder(s)
PLoS neglected tropical diseases
Bibliographic Citation
Limmathurotsakul D, Kanoksil M, Wuthiekanun V, Kitphati R, deStavola B, Day NP, et al. Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. PLoS Negl Trop Dis. 2013;7(2):e2072
Suggested Citation
Direk Limmathurotsakul, ดิเรก ลิ้มมธุรสกุล, Manas Kanoksil, Vanaporn Wuthiekanun, วรรณพร วุฒิเอกอนันต์, Rungrueng Kitphati, Stavola, Bianca de, Day, Nicholas P.J., Peacock, Sharon J. Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. Limmathurotsakul D, Kanoksil M, Wuthiekanun V, Kitphati R, deStavola B, Day NP, et al. Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. PLoS Negl Trop Dis. 2013;7(2):e2072. doi:10.1371/journal.pntd.0002072 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/823
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Title
Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study
Corresponding Author(s)
Abstract
BACKGROUND: 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.