Two fatal cases of melioidosis on the Thai-Myanmar border

Abstract

Melioidosis is endemic in areas of Southeast Asia, however, there are no published reports from the Thai-Myanmar border. We report the first two documented cases of fatal melioidosis in this region. This is of great public health importance and highlights the need to both increase clinical awareness of melioidosis on the Thai-Myanmar border, and to assess the true burden of disease in the area through improved case detection and Burkholderia pseudomallei prevalence studies.

Fever and health-seeking behaviour among migrants living along the Thai-Myanmar border: a mixed-methods study

“…In rural northern Thailand, a public health campaign aiming to limit antibiotic use was followed by a drastic reduction of general medicine availability in informal shops, pressurising villagers to seek health in hospital, 9-10 kilometres away from their village, even for mild symptoms such as headache 51 . Ignoring the language terminology and population beliefs may, therefore, worsen symptom identi cation and response, while being irrelevant to alleviate the burden of both febrile illness and AMR in Southeast Asia [5][6][7][8]54 .…”

“…Our study brings in-depth understanding of fever conception and its believed causes, and identi es determinants associated with health-seeking behaviour amongst migrants from the Thai-Myanmar border where the burden of fever is high [5][6][7][8][9][10][11][12] . The only comparable study in the region was carried out in the early 2000s, whereas the economic context has dramatically changed since then, with a USD15 billion China-Thailand-Myanmar Special Economic Zone, and over USD25 billion-a-year gaming industry constructed on the Myanmar side of the border since 2019 37 .…”

“…Fever is one of the most frequent reasons for seeking health in Southeast Asia, particularly at the community-level [1][2][3][4] . Its burden is illustrated by repeated bacterial and viral outbreaks, as well as the emergence of severe infections such as melioidosis or multi-drug resistant tuberculosis [5][6][7][8][9] , and these are frequently reported amongst migrants, mainly because of limited healthcare access [10][11][12] . In parallel, the burden of malaria has reduced substantially over the past decade, through wide access to point-of-care tests providing a clear therapeutic guidance 13 .…”

A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border

“…SMRU is located in Tak Province on the Thai side of the border with Myanmar and a map of the clinic locations has been published previously [ 11 ]. The three busiest clinics were included for the piloting of the teaching tool: namely Mae La (MLA), Wang Pha (WPA) and Mawker Thai (MKT).…”

“…The case-mix has changed dramatically over the past decade in the refugees [ 13 ] and past five years in the migrants [ 14 ]. There has been a significant reduction in malaria in the refugee and migrant communities with a relative increase in acute non-malaria presentations such as sepsis and obstetric complications [ 11 ]. The need for improved competence was recognised by medical faculty and in review of the teaching programme that had been delivered in the past year (Jan-13 to March-14).…”