Warner J M, Pelowa D B, Currie B J, Hirst R G
Microbiology and Immunology, School of Veterinary and Biomedical Sciences, James Cook University, Townsville, Qld 4811, Australia.
Trans R Soc Trop Med Hyg. 2007 Aug;101(8):809-13. doi: 10.1016/j.trstmh.2007.02.024. Epub 2007 May 11.
A prospective study was conducted to determine the significance of melioidosis in the Balimo district of Western Province, Papua New Guinea. During 1998, after the establishment of laboratory procedures and increasing local clinical awareness, the disease was found in 1.8% (95% CI 0.37-5.1%) of individuals presenting with fever refractory to standard treatment. The clinical incidence was 20.0 per 100,000 population (95% CI 12.2-30.9). The median age of culture-confirmed cases was 9.5 years (interquartile range 8.3-14.8 years). The seroprevalence of 747 community children in the region tested was 8.2% (95% CI 6.2-10.4%). Most individuals presented during the rainy season with a febrile disease refractory to standard treatment, sometimes mimicking tuberculosis. Some family clustering was apparent. All patients with bacteraemic melioidosis died, but treatment with the available conventional therapies of chloramphenicol, co-trimoxazole or doxycycline resulted in survival and cure in six patients with subacute/localised melioidosis. Further studies are needed to ascertain the local epidemiology and why children appear particularly at risk, as well as to establish the true extent of melioidosis in Papua New Guinea.
开展了一项前瞻性研究，以确定类鼻疽在巴布亚新几内亚西部省份巴利莫区的重要性。1998年期间，在建立实验室检测程序并提高当地临床意识之后，在标准治疗无效的发热患者中，该病的检出率为1.8%（95%可信区间0.37 - 5.1%）。临床发病率为每10万人口20.0例（95%可信区间12.2 - 30.9）。培养确诊病例的中位年龄为9.5岁（四分位间距8.3 - 14.8岁）。对该地区747名社区儿童进行检测，血清阳性率为8.2%（95%可信区间6.2 - 10.4%）。大多数患者在雨季出现标准治疗无效的发热疾病，有时类似结核病。有明显的家庭聚集现象。所有菌血症性类鼻疽患者均死亡，但采用可用的常规疗法氯霉素、复方新诺明或强力霉素治疗，使6例亚急性/局限性类鼻疽患者存活并治愈。需要进一步研究以确定当地的流行病学情况、儿童为何似乎特别易感，以及确定巴布亚新几内亚类鼻疽的实际流行程度。
