Extreme Weather and Melioidosis: An endemic tropical disease in Penampang district of Sabah, Malaysia

Authors

Sam Froze Jiee, Department of Disease Control, Penampang District Health Office, Sabah State Health Department, Ministry of Health, MalaysiaFollow
Kai Joo Lim, Department of Disease Control, Penampang District Health Office, Sabah State Health Department, Ministry of Health, Malaysia
Daryl Sin Choon Vui, Communicable Disease Control and Surveillance Unit, Department of Disease Control, Penampang District Health Office, Ministry of Health, Malaysia
Dina Peter Marius, Communicable Disease Control and Surveillance Unit, Department of Disease Control, Penampang District Health Office, Ministry of Health, Malaysia
Nurul Syafiqah Illyana, Communicable Disease Control and Surveillance Unit, Department of Disease Control, Penampang District Health Office, Ministry of Health, Malaysia
Anisah Jantim, Penampang District Health Office, Ministry of Health, Malaysia

Abstract

Background: Melioidosis is a fatal, but preventable communicable disease that is endemic in several parts of the world, including the state of Sabah, Malaysia, which is located in the northern part of Borneo Island. Flooding is one of the most regular natural disasters affecting some parts of Malaysia, including Sabah. The main aim of this study was to determine if rainfall and floods were significant risk factors contributing to the substantial burden of melioidosis in the Penampang district from 2015 to 2020.

Method: We analyzed 64 culture-confirmed cases of melioidosis in the Penampang district, Sabah, between 2015 and 2020 to determine if rainfall and floods were significant risk factors that contributed to the substantial burden of melioidosis. Fisher’s exact test was used to examine for associations between risk factors and melioidosis mortality. We used Poisson regression to calculate the incidence rate ratio for melioidosis cases based on different risk factors.

Results: There was a linear association between rainfall and floods with cases of melioidosis. Our Poisson regression results indicated that the number of melioidosis cases was 1.002 times greater with every 1 mm increase of rainfall and 2.203 times greater with every flood event. There was a linear association between cases of melioidosis with rainfall and floods, with most patients having comorbidities.

Conclusion: Prevention of melioidosis in the Penampang district should primarily focus on avoiding direct contact with soil or contaminated water, especially during or after extreme weather events. Continuous and community-empowered health education targeting the high-risk group is essential, as flash floods in certain parts of the state and districts are seasonal and unpredictable.

Keywords: Melioidosis, Extreme weather, Heavy rainfalls, Malaysia

Recommended Citation

Jiee S, Lim K, Choon Vui D, Marius D, Illyana N, Jantim A. Extreme Weather and Melioidosis: An endemic tropical disease in Penampang district of Sabah, Malaysia. J Health Res. 2023; 37(5):297-305. DOI: https://doi.org/10.56808/2586-940X.1023

References

[1] Whitmore A. An account of a glanders-like disease occurring in Rangoon. J Hyg 1913;13(1):1-34.1. https://doi.org/10.1017/s0022172400005234.

[2] Inglis TJ, Sousa AQ. The public health implications of melioidosis. Braz J Infect Dis 2009;13(1):59-66. https://doi.org/10.1590/s1413-86702009000100013.

[3] Mustafa M. Epidemiology of melioidosis in Sabah: study on melioidosis. Riga, Latvia: LAP Lambert Academic Publishing; 2012.

[4] Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 2007;20(3):533. https://doi.org/10.1128/CMR.00018-07. Erratum for: ClinMicrobiol Rev. 2005; 18(2): 383-416.

[5] Virk HS, Mukhopadhyay C, Wiersinga WJ. Melioidosis: a neglected cause of community-acquired pneumonia. Semin Respir Crit Care Med 2020;41(4):496-508. https://doi.org/10.1055/s-0040-1710570.

[6] Hanson J, Smith S, Stewart J, Horne P, Ramsamy N. Melioidosis-a disease of socioeconomic disadvantage. PLoS Neglected Trop Dis 2021;15(6):e0009544. https://doi.org/10.1371/journal.pntd.0009544.

[7] Mohapatra PR, Mishra B. Burden of melioidosis in India and South Asia: challenges and ways forward. Lancet Reg Health South Asia 2022;2:100004. https://doi.org/10.1016/j.lansea.2022.03.004.

[8] Bhengsri S, Lertiendumrong J, Baggett HC, Thamthitiwat S, Chierakul W, Tisayaticom K, et al. Economic burden of bacteremic melioidosis in eastern and northeastern, Thailand. Am J Trop Med Hyg 2013;89(2):369-73. https://doi.org/10.4269/ajtmh.13-0148.

[9] Mardhiah K, Wan-Arfah N, Naing NN, Abu Hassan MR, Chan HK, Hasan H. The trend of direct medical cost of meliodiosis patients in Kedah: a retrospective study from 2014 to 2017. Clinicoecon Outcomes Res 2021;13:155-62. https://doi.org/10.2147/CEOR.S286283.

[10] Abu Hassan MR, Aziz N, Ismail N, Shafie Z, Mayala B, Donohue RE, et al. Socio-epidemiological and land cover risk factors for melioidosis in Kedah, Northern Malaysia. PLoS Neglected Trop Dis 2019;13(3):e0007243. https://doi.org/10.1371/journal.pntd.0007243.

[11] Limmathurotsakul D, Golding N, Dance DA, Messina JP, Pigott DM, Moyes CL, et al. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol 2016;1(1):15008. https://doi.org/10.1038/nmicrobiol.2015.8.

[12] Gibney KB, Cheng AC. Reducing the melioidosis burden: public health, chronic disease prevention, or improved case management? Lancet Infect Dis 2019;19(8):800-2. https://doi.org/10.1016/S1473-3099(19)30303-2.

[13] Suleiman M, Kundayis F, Polin P, Gindono J. Guideline for clinical and public health management of melioidosis in Sabah [updated 2014; cited 2022 May 1]. Available from: http://www.jknsabah.gov.my/v2/muatturun/kesihatanawam/GarisPanduanPenyakitBerjangkit/Guideline%20For%20Clinixcal%20and%20Public%20Health%20Management%20Of%20Melioidosis%20In%20Sabah.pdf.

[14] World Bank. Climate change knowledge portal [updated 2021; cited 2022 May 1]. Available from: https://climateknowledgeportal.worldbank.org/country/malaysia/climate-data-historical.

[15] Malaysian Meteorological Department. Technical paper: Rainfall. Sabah: Malaysian Meteorological Department; 2021.

[16] Malaysia Meteorological Department Reports [updated 2022; cited 2022 May 6]. Available from: https://www.met.gov.my/iklim/laporanringkasan/buletincuacabulanan.

[17] Outbreak News Today. Australia: melioidosis increase reported in top end [updated 2022; cited 2022 April 27]. Available from: http://outbreaknewstoday.com/australiamelioidosis-increase-reported-in-top-end-90250/.

[18] Hassan MR, Pani SP, Peng NP, Voralu K, Vijayalakshmi N, Mehanderkar R, et al. Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia. BMC Infect Dis 2010;10:302. https://doi.org/10.1186/1471-2334-10-302.

[19] Bhengsri S, Lertiendumrong J, Baggett HC, Thamthitiwat S, Chierakul W, Tisayaticom K, et al. Economic burden of bacteremic melioidosis in eastern and northeastern, Thailand. Am J Trop Med Hyg 2013;89(2):369-73. https://doi.org/10.4269/ajtmh.13-0148.

[20] Chai LYA, Fisher D. Earth, wind, rain, and melioidosis. Lancet Planet Health 2018;2(8):e329-30. https://doi.org/10.1016/S2542-5196(18)30165-7. Erratum in: Lancet Planet Health. 2019; 3(2): e70.

[21] Thummakul T, Wilde H, Tantawichien T. Melioidosis, an environmental and occupational hazard in Thailand. Mil Med 1999;164(9):658-62.

[22] Shrestha N, Adhikari M, Pant V, Baral S, Shrestha A, Basnyat B, et al. Melioidosis: misdiagnosed in Nepal. BMC Infect Dis 2019;19(1):176. https://doi.org/10.1186/s12879-019-3793-x.

[23] Nathan S, Chieng S, Kingsley PV, Mohan A, Podin Y, Ooi MH, et al. Melioidosis in Malaysia: incidence, clinical challenges, and advances in understanding pathogenesis. Trav Med Infect Dis 2018;3(1):25. https://doi.org/10.3390/tropicalmed3010025.

[24] World Meteorological Organization [WMO]. Climate change and extreme weather [updated 2022; cited 2022 May 1]. Available from: https://public.wmo.int/en/resources/worldmeteorological-day/world-meteorological-day-2022-earlywarning- early-action/climate-change-and-extreme-weather.

[25] Shaw T, Assig K, Tellapragada C, Wagner GE, Choudhary M, Gohler A, et al. Environmental factors associated with soil prevalence of the melioidosis pathogen Burkholderia pseudomallei: a longitudinal seasonal study from South West India. Front Microbiol 2022;13:902996. https://doi.org/10.3389/fmicb.2022.902996.

[26] Lau SK, Sridhar S, Ho CC, Chow WN, Lee KC, Lam CW, et al. Laboratory diagnosis of melioidosis: past, present and future. Exp Biol Med 2015;240(6):742-51. https://doi.org/10.1177/1535370215583801.

[27] Puthucheary SD. Melioidosis in Malaysia. Med J Malaysia 2009;64(4):266-74.

[28] Tang RY, Lim SH, Lam JE, Nurasykin S, Eileen T, Chan YW. A 5-year retrospective study of melioidosis cases treated in a district specialist hospital. Med J Malaysia 2019;74(6):472-6.

[29] Al-Naggar RA, Bobryshev YV, Mohd Noor NA. Lifestyle practice among Malaysian university students. Asian Pac J Cancer Prev 2013;14(3):1895-903. https://doi.org/10.7314/apjcp.2013.14.3.1895.

[30] Yokokawa H, Fukuda H, Yuasa M, Sanada H, Hisaoka T, Naito T. Association between health literacy and metabolic syndrome or healthy lifestyle characteristics among community-dwelling Japanese people. Diabetol Metab Syndrome 2016;8:30. https://doi.org/10.1186/s13098-016-0142-8.

[31] Kingsley PV, Leader M, Nagodawithana NS, Tipre M, Sathiakumar N. Melioidosis in Malaysia: a review of case reports. PLoS Neglected Trop Dis 2016;10(12):e0005182. https://doi.org/10.1371/journal.pntd.0005182.

[32] Zueter A, Yean CY, Abumarzouq M, Rahman ZA, Deris ZZ, Harun A. The epidemiology and clinical spectrum of melioidosis in a teaching hospital in a North-Eastern state of Malaysia: a fifteen-year review. BMC Infect Dis 2016;16:333. https://doi.org/10.1186/s12879-016-1583-2.

[33] Menon R, Baby P, Kumar VA, Surendran S, Pradeep M, Rajendran A, et al. Risk factors for mortality in melioidosis: a single-centre, 10-year retrospective cohort study. Sci World J 2021;2021:8154810. https://doi.org/10.1155/2021/8154810.

[34] Chowdhury S, Barai L, Afroze SR, Ghosh PK, Afroz F, Rahman H, et al. The epidemiology of melioidosis and its association with diabetes mellitus: a systematic review and meta-analysis. Pathogens 2022;11(2):149. https://doi.org/10.3390/pathogens11020149.

[35] Chaturvedi N. Ethnic differences in cardiovascular disease. Heart 2003;89(6):681-6. https://doi.org/10.1136/heart.89.6.681.

[36] Pengpid S, Peltzer K. The prevalence and social determinants of fruit and vegetable consumption among adults in Kenya: a cross-sectional national population-based survey, 2015. Pan Afr Med J 2018;31:137. https://doi.org/10.11604/pamj.2018.31.137.17039.

[37] World Health Organization [WHO]. Malaysia health system review. Geneva: WHO; 2013 [cited 2022 May 1]. Available from: https://apps.who.int/iris/handle/10665/206911.