Suputtamongkol Y, Hall A J, Dance D A, Chaowagul W, Rajchanuvong A, Smith M D, White N J
Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Int J Epidemiol. 1994 Oct;23(5):1082-90. doi: 10.1093/ije/23.5.1082.
Melioidosis, or infection with Pseudomonas pseudomallei is an important cause of morbidity and mortality in South East Asia and Northern Australia. The epidemiology of melioidosis in Ubon Ratchatani, Northeast Thailand was studied over a 5-year period from 1987 to 1991.
Rates and, when possible, the risks of developing melioidosis were calculated. The numerator was the number of culture-proven cases of melioidosis seen in the 1000-bed referral hospital of the province. The denominators were obtained from the population census, a survey of Health, Welfare and Use of Traditional Medicine, and the North Eastern Meterological Centre, Thailand.
The average incidence of human melioidosis was 4.4 (95% confidence interval [CI]: 3.8-5.0) per 100,000. The disease affected all ages with the highest incidence in 40-60 years olds. Melioidosis was 1.4 (95% CI: 0.4-5.3) times more common in males than females. The disease showed a significant seasonal variation in incidence, and a strong linear correlation with rainfall (r = 0.7, 95% CI: 0.5-0.9) Adults exposed to soil and water in their work (most were rice farmers) had an increased risk of melioidosis (in the 40-59 year age group, relative risk = 4.1, 95% CI: 2.4-6.9). Most adult patients had an underlying disease (mainly diabetes mellitus) predisposing them to this infection.
Melioidosis may result from either acute exposure to the organism in the soil and water, or 're-activation' of an asymptomatic childhood infection (by an unidentified possibly infective seasonal cofactor). The results from this analysis are consistent with both hypotheses. Further epidemiological studies are needed to identify risk factors so that optimal strategies for control of melioidosis may be developed.
类鼻疽病，即由类鼻疽杆菌感染所致，是东南亚和澳大利亚北部发病和死亡的重要原因。1987年至1991年的5年间，对泰国东北部乌汶叻差他尼府的类鼻疽病流行病学情况进行了研究。
计算类鼻疽病的发病率以及（若可能）发病风险。分子为该省拥有1000张床位的转诊医院中经培养证实的类鼻疽病病例数。分母来自人口普查、健康、福利及传统医学使用情况调查以及泰国东北部气象中心的数据。
人类类鼻疽病的平均发病率为每10万人4.4例（95%置信区间[CI]：3.8 - 5.0）。该疾病影响所有年龄段，40至60岁人群发病率最高。男性患类鼻疽病的几率是女性的1.4倍（95% CI：0.4 - 5.3）。该疾病发病率呈现出显著的季节性变化，且与降雨量呈强线性相关（r = 0.7，95% CI：0.5 - 0.9）。工作中接触土壤和水的成年人（大多数是稻农）患类鼻疽病的风险增加（在40至59岁年龄组中，相对风险 = 4.1，95% CI：2.4 - 6.9）。大多数成年患者有基础疾病（主要是糖尿病），使其易感染此病。
类鼻疽病可能源于在土壤和水中急性接触该病原体，或者（通过一个未明确的可能具有感染性的季节性辅助因素）使无症状的儿童期感染“重新激活”。本分析结果与这两种假设均相符。需要进一步开展流行病学研究以确定风险因素，从而制定出控制类鼻疽病的最佳策略。
