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LETTER TO EDITOR
Year : 2019  |  Volume : 8  |  Issue : 4  |  Page : 412

Concurrent melioidosis and tuberculosis: An expected incidence in endemic tropical country


1 RVT Medical Academic Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India

Date of Submission03-Oct-2019
Date of Acceptance07-Oct-2019
Date of Web Publication26-Nov-2019

Correspondence Address:
Won Sriwijitalai
RVT Medical Academic Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmy.ijmy_148_19

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How to cite this article:
Sriwijitalai W, Wiwanitkit V. Concurrent melioidosis and tuberculosis: An expected incidence in endemic tropical country. Int J Mycobacteriol 2019;8:412

How to cite this URL:
Sriwijitalai W, Wiwanitkit V. Concurrent melioidosis and tuberculosis: An expected incidence in endemic tropical country. Int J Mycobacteriol [serial online] 2019 [cited 2019 Dec 7];8:412. Available from: http://www.ijmyco.org/text.asp?2019/8/4/412/271475



Dear Editor,

Tuberculosis is an important mycobacterial infection that is still global public health consideration. This mycobacterial infection is still endemic in several developing countries. In tropical zone, there are also other problematic endemic infections. The change for concurrence between tuberculosis and other common local endemic infection is interesting. The good example is the previous report on the concurrence between tuberculosis and dengue.[1] Here, the authors performed an additional clinical epidemiological investigation to assess the chance for concurrent melioidosis and tuberculosis. The setting is Thailand, a tropical country in Southeast Asia where there are high incidence rates of both melioidosis and tuberculosis. First, the authors used the technique that is mentioned in the previous publication[1] for developing a mathematical model based on jointed probability principle for estimation for chance of concurrent melioidosis and tuberculosis. According to the mathematical model, the formula for calculation for expected incidence of concurrent melioidosis and tuberculosis is “expected incidence of co-occurrence between tuberculosis and melioidosis = incidence of tuberculosis x incidence of melioidosis.” The official data derived from Thai Center of Disease (CDC) Control are used in the analysis. Based on the local Thai data from Thai CDC, the incidences of melioidosis and tuberculosis are equal to 4.96/100,000 population and 171/100,000 population, respectively. Therefore, the derived expected incidence of concurrent melioidosis and tuberculosis is equal to 0.0085/100,000 population or 8.5 patients per hundred millions of local people. This derived rare is extremely low, and it can explain the rare nature of the concurrence. Indeed, in our setting, in Thailand, there has never been any report on concurrent melioidosis and tuberculosis. Worldwide, limited case reports on the concurrent melioidosis and tuberculosis are published. In India, a country that is larger than Thailand and with more population, the two diseases are also common; there is a previous case report on co-occurrence between melioidosis and tuberculosis in the patient with underlying diabetes mellitus.[2] This report can confirm the rarity of the concurrence.[2] In Malaysia, another populated country in Southeast Asia, there is a previous report showing that tuberculosis is an important underlying comorbidity in death cases with melioidosis.[3] In that report, the patients with concurrent disease are from South Asia.[3]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Joob B, Wiwanitkit V. Concurrent dengue and tuberculosis: An estimated incidence in endemic tropical country and explanation for low observed incidence. Biomed Biotechnol Res J 2019;3:111-6.  Back to cited text no. 1
  [Full text]  
2.
Shetty AK, Boloor R, Sharma V, Bhat GH. Melioidosis and pulmonary tuberculosis co-infection in a diabetic. Ann Thorac Med 2010;5:113-5.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Kingsley PV, Leader M, Nagodawithana NS, Tipre M, Sathiakumar N. Melioidosis in Malaysia: A review of case reports. PLoS Negl Trop Dis 2016;10:e0005182.  Back to cited text no. 3
    




 

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