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Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia

Currie, Bart J., Jacups, Susan P., Cheng, Allen C., Fisher, Dale A., Anstey, Nicholas M., Huffam, Sarah E. and Krause, Vicki L. (2004). Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia. Tropical Medicine and International Health,9(11):1167-1174.

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Title Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia
Author Currie, Bart J.
Jacups, Susan P.
Cheng, Allen C.
Fisher, Dale A.
Anstey, Nicholas M.
Huffam, Sarah E.
Krause, Vicki L.
Journal Name Tropical Medicine and International Health
Publication Date 2004
Volume Number 9
Issue Number 11
ISSN 1360-2276   (check CDU catalogue  open catalogue search in new window)
Start Page 1167
End Page 1174
Total Pages 8
Place of Publication UK
Publisher Wiley-Blackwell Publishing Ltd.
Field of Research 1117 - Public Health and Health Services
HERDC Category C1 - Journal Article (DEST)
Abstract Objectives
The aims of this study were to describe the epidemiology of melioidosis in tropical northern Australia and to assess the importance of defined risk factors.

Methods
The data were taken from a 14-year prospective study of 364 cases of melioidosis in the ‘Top End’ of the Northern Territory. A whole-population logistic regression model was used to estimate the crude and adjusted relative risk (RR) for the defined risk factors.

Results
The mean age of the study population was 46.8 years, 264 (72.5%) were male, 178 (49%) were aboriginal Australians and 59 (16.2%) died from melioidosis. Average annual incidence was 19.6 cases per 100 000 population, with an estimated rate of 260 cases per 100 000 diabetics per year. Using a whole-population logistic regression model, the estimated crude and adjusted RR [95% confidence intervals (CI)] for melioidosis were 6.3 (5.1–7.8) and 4.0 (3.2–5.1) for those aged ≥ 45 years, 2.3 (1.8–2.9) and 2.4 (1.9–3.0) for males, 2.9 (2.3–3.5) and 3.0 (2.3–4.0) for aboriginal Australians, 21.2 (17.1–26.3) and 13.1 (9.4–18.1) for diabetics, 2.7 (2.2–3.4) and 2.1 (1.6–2.6) for those with excess alcohol consumption, 6.8 (5.4–8.6) and 4.3 (3.4–5.5) for chronic lung disease and 6.7 (4.7–9.6) and 3.2 (2.2–4.8) for chronic renal disease, respectively.

Conclusions
Diabetes, excess alcohol intake, chronic renal disease and chronic lung disease are each independent risk factors for melioidosis. In tropical northern Australia, male sex, aboriginal ethnicity and age of ≥45 years are also independent predictors for melioidosis. Impaired polymorph function may be critical in the predisposition to melioidosis.
Keywords melioidosis
Burkholderia pseudomallei
epidemiology
comorbidity
endemic diseases
Australia
aboriginal
DOI http://dx.doi.org/10.1111/j.1365-3156.2004.01328.x   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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