Melioidosis in Thailand: Present and Future.
Melioidosis in Thailand: Present and Future.
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DOI：
10.3390/tropicalmed3020038
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发表时间：
2018
影响因子：
2.9
通讯作者：
Limmathurotsakul D
中科院分区：
文献类型：
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作者：
Hinjoy S;Hantrakun V;Kongyu S;Kaewrakmuk J;Wangrangsimakul T;Jitsuronk S;Saengchun W;Bhengsri S;Akarachotpong T;Thamthitiwat S;Sangwichian O;Anunnatsiri S;Sermswan RW;Lertmemongkolchai G;Tharinjaroen CS;Preechasuth K;Udpaun R;Chuensombut P;Waranyasirikul N;Anudit C;Narenpitak S;Jutrakul Y;Teparrukkul P;Teerawattanasook N;Thanvisej K;Suphan A;Sukbut P;Ploddi K;Sirichotirat P;Chiewchanyon B;Rukseree K;Hongsuwan M;Wongsuwan G;Sunthornsut P;Wuthiekanun V;Sachaphimukh S;Wannapinij P;Chierakul W;Chewapreecha C;Thaipadungpanit J;Chantratita N;Korbsrisate S;Taunyok A;Dunachie S;Palittapongarnpim P;Sirisinha S;Kitphati R;Iamsirithaworn S;Chaowagul W;Chetchotisak P;Whistler T;Wongratanacheewin S;Limmathurotsakul D
最近的一项模拟研究估计，泰国每年有2800人死于类鼻疽。泰国类鼻疽网络（成立于2012年）一直与公共卫生部密切合作，调查和减少这种疾病的负担。根据最新数据，类鼻疽的发病率在泰国东北部仍然很高。每年在该地区设有微生物实验室的综合医院诊断出2000多例经培养确诊的类鼻疽病例。死亡率在35%左右。类鼻疽是泰国的地方病，但微生物设施将类鼻疽伯克霍尔德菌误认为污染物或另一种微生物的情况仍不少见。疾病意识低，农村地区的人们在喝水前既不穿靴子也不烧开水，以保护自己不感染B。假鼻疽此前，每年约有10例类鼻疽死亡病例正式报告给国家法定传染病监测系统（报告506），从而限制了卫生部的优先事项设定。2015年，正式报告的类鼻疽死亡人数上升至112人，这完全是因为乌汶府Sunpasithiprasong医院报告了自己的数据（n = 107）。类鼻疽确实是泰国的一个重要死因，目前报告的病例（报告506）和研究中心诊断的病例反映了冰山一角。实验室培训和临床医生和实验室人员之间的沟通，以提高全国类鼻疽的诊断和治疗。迫切需要实施快速诊断测试，例如侧流抗原检测测定，即使在像泰国这样的类鼻疽流行国家也具有高准确性。根据《传染病法案》B.E.2558的规定，必须报告每家拥有微生物实验室的医院的所有经培养确诊的类鼻疽病例以及最终结果数据。通过执行这项立法，公共卫生部可以提高对这一疾病的重视程度，并应考虑在全国范围内开展提高认识和预防类鼻疽的运动。
A recent modelling study estimated that there are 2800 deaths due to melioidosis in Thailand yearly. The Thailand Melioidosis Network (formed in 2012) has been working closely with the Ministry of Public Health (MoPH) to investigate and reduce the burden of this disease. Based on updated data, the incidence of melioidosis is still high in Northeast Thailand. More than 2000 culture-confirmed cases of melioidosis are diagnosed in general hospitals with microbiology laboratories in this region each year. The mortality rate is around 35%. Melioidosis is endemic throughout Thailand, but it is still not uncommon that microbiological facilities misidentify Burkholderia pseudomallei as a contaminant or another organism. Disease awareness is low, and people in rural areas neither wear boots nor boil water before drinking to protect themselves from acquiring B. pseudomallei. Previously, about 10 melioidosis deaths were formally reported to the National Notifiable Disease Surveillance System (Report 506) each year, thus limiting priority setting by the MoPH. In 2015, the formally reported number of melioidosis deaths rose to 112, solely because Sunpasithiprasong Hospital, Ubon Ratchathani province, reported its own data (n = 107). Melioidosis is truly an important cause of death in Thailand, and currently reported cases (Report 506) and cases diagnosed at research centers reflect the tip of the iceberg. Laboratory training and communication between clinicians and laboratory personnel are required to improve diagnosis and treatment of melioidosis countrywide. Implementation of rapid diagnostic tests, such as a lateral flow antigen detection assay, with high accuracy even in melioidosis-endemic countries such as Thailand, is critically needed. Reporting of all culture-confirmed melioidosis cases from every hospital with a microbiology laboratory, together with final outcome data, is mandated under the Communicable Diseases Act B.E.2558. By enforcing this legislation, the MoPH could raise the priority of this disease, and should consider implementing a campaign to raise awareness and melioidosis prevention countrywide.