Burden of Burkholderia pseudomallei in Nepal to inform vaccine needs (BURNEP study)
Led by Dr Suraj Bhattarai (Global Health Research & Medical Interventions Institute (GLOHMED), Kathmandu, Nepal), with Professor Ivo Steinmetz (Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz (MUG), Austria)
Project Aim
Melioidosis is caused by the soil bacterium Burkholderia (B.) pseudomallei which can infect humans through inhalation of soil-contaminated aerosols, skin lesions, or ingestion of contaminated water or food. It is suggested that around 44% of the predicted total 165,000 annual melioidosis cases worldwide occur in South Asian countries. So far, only sporadic cases of melioidosis have been reported in Nepal. However, Nepal is likely to be a highly endemic country for B. pseudomallei, for the following three reasons. First, over half of the total population (around 15 million) live in the Southern belt with environmental suitability for B. pseudomallei. Second, two-thirds of the population are involved in farming or agriculture. And third, there is a high prevalence of diabetes among Nepalese adults. However, due to lack of awareness and limited microbiological capacity, there is massive underreporting of cases.
The aim of the proposed study is to provide a first estimate on the number of B. pseudomallei infections in the country and understand clinical and socio-epidemiological characteristics of cases. To achieve this, we will recruit 800 adult patients from four hospitals, each presenting with febrile illness and having at least one known risk factor for melioidosis. Simple laboratory methods will be applied to detect B. pseudomallei from blood samples, but also urine, sputum and pus. Bacterial isolates and sera will be stored for advanced molecular and serological tests, which will be conducted by our Austrian partner and later implemented in Nepal. Our project will help to provide an initial assessment of the risk areas and risk groups in Nepal that will benefit from a melioidosis vaccine.
Additionally, as an offshoot of the VALIDATE Pump-Priming Grant, we aim to formally establish the Nepal Burkholderia Network- NEBUNET, which will drive further research and knowledge/ skills transfer in the region.
