Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study.
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 evid...
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ftdoajarticles:oai:doaj.org/article:dba9348bdb7a475e84b02a75745e7dfe 2023-05-15T15:17:53+02:00 Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. Direk Limmathurotsakul Manas Kanoksil Vanaporn Wuthiekanun Rungrueng Kitphati Bianca deStavola Nicholas P J Day Sharon J Peacock 2013-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002072 https://doaj.org/article/dba9348bdb7a475e84b02a75745e7dfe EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3578767?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002072 https://doaj.org/article/dba9348bdb7a475e84b02a75745e7dfe PLoS Neglected Tropical Diseases, Vol 7, Iss 2, p e2072 (2013) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2013 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002072 2022-12-31T08:54:37Z 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.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).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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 7 2 e2072 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Direk Limmathurotsakul Manas Kanoksil Vanaporn Wuthiekanun Rungrueng Kitphati Bianca deStavola Nicholas P J Day Sharon J Peacock Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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.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).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. |
format |
Article in Journal/Newspaper |
author |
Direk Limmathurotsakul Manas Kanoksil Vanaporn Wuthiekanun Rungrueng Kitphati Bianca deStavola Nicholas P J Day Sharon J Peacock |
author_facet |
Direk Limmathurotsakul Manas Kanoksil Vanaporn Wuthiekanun Rungrueng Kitphati Bianca deStavola Nicholas P J Day Sharon J Peacock |
author_sort |
Direk Limmathurotsakul |
title |
Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. |
title_short |
Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. |
title_full |
Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. |
title_fullStr |
Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. |
title_full_unstemmed |
Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. |
title_sort |
activities of daily living associated with acquisition of melioidosis in northeast thailand: a matched case-control study. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2013 |
url |
https://doi.org/10.1371/journal.pntd.0002072 https://doaj.org/article/dba9348bdb7a475e84b02a75745e7dfe |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 7, Iss 2, p e2072 (2013) |
op_relation |
http://europepmc.org/articles/PMC3578767?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002072 https://doaj.org/article/dba9348bdb7a475e84b02a75745e7dfe |
op_doi |
https://doi.org/10.1371/journal.pntd.0002072 |
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PLoS Neglected Tropical Diseases |
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7 |
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2 |
container_start_page |
e2072 |
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1766348141739638784 |