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Trop Med Infect Dis. 2018 Mar 13;3(1). pii: E32. doi: 10.3390/tropicalmed3010032.

Emergence of Melioidosis in Indonesia and Today's Challenges.

Author information

1
Department of Clinical Pathology, Faculty of Medicine, Universitas Hasanuddin/Dr. Wahidin Sudirohusodo Hospital, Makassar 90245, Indonesia. pattauran@yahoo.com.
2
Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta 10560, Indonesia. pattauran@yahoo.com.
3
Laboratory of Clinical Pathology, Abdul Wahab Sjahranie Hospital, Samarinda 75123, Indonesia. ayusriwahyunie@gmail.com.
4
Laboratory of Clinical Pathology, Tarakan Hospital, Jakarta10150, Indonesia. farasaad@yahoo.com.
5
Department of Clinical Pathology, Faculty of Medicine, Universitas GadjahMada/Sardjito Hospital, Yogyakarta 55281, Indonesia. adahesihdewi@yahoo.com.
6
Laboratory of Clinical Pathology, Prof. Dr. WZ Johannes Hospital, Kupang 85112, Indonesia. graciella1602@yahoo.com.
7
Department of Microbiology, Faculty of Medicine, Universitas Hasanuddin/Hasanuddin University Hospital, Makassar 90245, Indonesia. dr.munawirmuhammad@yahoo.co.id.
8
Department of Microbiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia. delly.c.lestari@gmail.com.
9
Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo Hospital, Surabaya 60286, Indonesia. dr_aryati@yahoo.com.
10
Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital, Bandung 40161, Indonesia. idaparwati2008@gmail.com.
11
Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia. tonnyloho@yahoo.com.
12
Department of Clinical Pathology, Faculty of Medicine, Universitas Lambung Mangkurat/Ulin Hospital, Banjarmasin 70233, Indonesia. indahhariadi@gmail.com.
13
Laboratory of Clinical Pathology, Dr. Zainoel Abidin Hospital, Banda Aceh 24415, Indonesia. vividahril@yahoo.com.
14
Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara/H. Adam Malik Hospital, North Sumatera 20136, Indonesia. loesnihari@yahoo.co.id.
15
Laboratory of Microbiology, Eka Hospital, Pekanbaru 28293, Indonesia. dewianggrainiyovi@gmail.com.
16
Department of Microbiology, Faculty of Medicine, Universitas Brawijaya/Saiful Anwar Hospital, Malang 65112, Indonesia. siwi_fk@ub.ac.id.
17
Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta 10560, Indonesia. wwahyunawang@gmail.com.
18
Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta 10560, Indonesia. ungkeajy@gmail.com.
19
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos. david.d@tropmedres.ac.
20
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford OX3 7FZ, UK. david.d@tropmedres.ac.
21
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. david.d@tropmedres.ac.
22
Tropical and Emerging Infectious Diseases Division, Menzies School of Health Research, Casuarina, Northern Territory 0811, Australia. bart.currie@menzies.edu.au.
23
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford OX3 7FZ, UK. direk@tropmedres.ac.
24
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand. direk@tropmedres.ac.
25
Department of Clinical Pathology, Faculty of Medicine, Universitas Hasanuddin/Dr. Wahidin Sudirohusodo Hospital, Makassar 90245, Indonesia. mansyurarif64@gmail.com.
26
Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta 10560, Indonesia. mansyurarif64@gmail.com.
27
Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta 10560, Indonesia. abutholibaman@ugm.ac.id.
28
Department of Microbiology, Faculty of Medicine, Universitas Gadjah Mada/Sardjito Hospital, Yogyakarta 55281, Indonesia. abutholibaman@ugm.ac.id.
29
Department of Microbiology, Faculty of Medicine, Universitas Udayana/Sanglah Hospital, Bali 80113, Indonesia. nyomansribudayanti@gmail.com.
30
Primate Research Center, Bogor Agricultural University, Bogor 16151, Indonesia. atie@indo.net.id.

Abstract

A recent modeling study estimated that there could be as many as 20,000 human melioidosis cases per year in Indonesia, with around 10,000 potential deaths annually. Nonetheless, the true burden of melioidosis in Indonesia is still unknown. The Indonesia Melioidosis Network was formed during the first melioidosis workshop in 2017. Here, we reviewed 101 melioidosis cases (99 human and two animal cases) previously reported and described an additional 45 human melioidosis cases. All 146 culture-confirmed cases were found in Sumatra (n = 15), Java (n = 104), Kalimantan (n = 15), Sulawesi (n = 11) and Nusa Tenggara (n = 1). Misidentification of Burkholderia pseudomallei was not uncommon, and most cases were only recently identified. We also evaluated clinical manifestations and outcome of recent culture-confirmed cases between 2012 and 2017 (n = 42). Overall, 15 (36%) cases were children (age <15 years) and 27 (64%) were adults (age ≥15 years). The overall mortality was 43% (18/42). We conducted a survey and found that 57% (327/548) of healthcare workers had never heard of melioidosis. In conclusion, melioidosis is endemic throughout Indonesia and associated with high mortality. We propose that top priorities are increasing awareness of melioidosis amongst all healthcare workers, increasing the use of bacterial culture, and ensuring accurate identification of B. pseudomalleiand diagnosis of melioidosis.

KEYWORDS:

Burkholderia pseudomallei; Indonesia; melioidosis

Conflict of interest statement

The authors declare no conflict of interest. The sponsors had no role in the design of the studies; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

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