Hodgetts, Kay

Kleinecke M

Woerle C

Kaestli M

Budd, Richard

Webb JR

Ward L

Mayo M

Currie, Bart

Meumann, Ella

2022-06-13

Melioidosis is endemic in the remote Katherine region of northern Australia. In a population with high rates of chronic disease, social inequities, and extreme remoteness, the impact of melioidosis is exacerbated by severe weather events and disproportionately affects First Nations Australians. All culture-confirmed melioidosis cases in the Katherine region of the Australian Top End between 1989-2021 were included in the study, and the clinical features and epidemiology were described. The diversity of Burkholderia pseudomallei strains in the region was investigated using genomic sequencing. From 1989-2021 there were 128 patients with melioidosis in the Katherine region. 96/128 (75%) patients were First Nations Australians, 72/128 (56%) were from a very remote region, 68/128 (53%) had diabetes, 57/128 (44%) had a history of hazardous alcohol consumption, and 11/128 (9%) died from melioidosis. There were 9 melioidosis cases attributable to the flooding of the Katherine River in January 1998; 7/9 flood-associated cases had cutaneous melioidosis, five of whom recalled an inoculating event injury sustained wading through flood waters or cleaning up after the flood. The 126 first-episode clinical B. pseudomallei isolates that underwent genomic sequencing belonged to 107 different sequence types and were highly diverse, reflecting the vast geographic area of the study region. In conclusion, melioidosis in the Katherine region disproportionately affects First Nations Australians with risk factors and is exacerbated by severe weather events. Diabetes management, public health intervention for hazardous alcohol consumption, provision of housing to address homelessness, and patient education on melioidosis prevention in First Nations languages should be prioritised.

Department of Infectious Diseases, Wellington Regional Hospital, Wellington, New Zealand.

Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.

Katherine District Hospital, Katherine, Northern Territory, Australia.

Department of Microbiology & Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.

PLoS Negl Trop Dis. 2022 Jun 13;16(6):e0010486. doi: 10.1371/journal.pntd.0010486.

0000-0001-7993-820X

https://pubmed.ncbi.nlm.nih.gov/35696415/?otool=iaurydwlib

https://hdl.handle.net/10137/12203

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Melioidosis in the remote Katherine region of northern Australia.

Journal Article

Publication