Underestimated health risk

Prof. Dr. Matthias Kohl (Faculty III – Health, Medical & Life Sciences) is involved as a statistician in a project dealing with a disease that is relatively unknown in this country: melioidosis. In tropical and subtropical regions an estimated 165,000 people per year contract this infection caused by the bacterium Burkholderia pseudomallei, and around 89,000 people die from the disease. The pathogens that cause melioidosis live in the soil. The disease is transmitted through aerosols, wound infections, or the ingestion of contaminated water or food. Since its symptoms range from pneumonia to abscesses in various organs to sepsis, the disease is difficult to diagnose – which is fatal, as early treatment with the right antibiotics is important. To make matters worse, little is known about whether the pathogen also occurs outside its main area of distribution in Asia.

Until now, data from Africa has been largely lacking. Researchers at the Medical University of Graz investigated the occurrence of melioidosis infections in Mali as part of a project. At a children's clinic run by Doctors Without Borders in Koutiala (Mali), they documented a total of 31 cases of melioidosis in children from infancy to five years of age based on samples collected there and laboratory data – the largest series of melioidosis cases ever reported in Africa. Prof. Dr. Matthias Kohl explains, “This suggests that the incidence of the disease is around 15.5 per 100,000 inhabitants per year.” Sequence data from the detected pathogens also confirmed a high degree of genetic diversity among the bacteria, says the mathematician, “Burkholderia pseudomallei has therefore been present in the area for some time, but has not yet been detected in patients due to a lack of diagnostic capabilities.”

This is precisely the problem − the pathogen is resistant to many common antibiotics. Patients who are not diagnosed quickly and correctly and are therefore treated incorrectly often die of melioidosis – in the present study, around 63% of the children admitted to the clinic. Together with his co-authors, Kohl therefore advises, “It is essential that better testing options be created quickly, which are also accessible under difficult conditions, so that children do not continue to die from a disease that is actually treatable.”

Paper “Melioidosis in Mali: a retrospective observational study"
(Lancet Glob Health 2025; 13: e1964 – e1972; doi: 10.1016/S2214-109X(25)00317-1)
von Sabine Lichtenegger, Isabel Klugherz, Gabriel E Wagner, Justine Michel, Bastien Mollo, Adama Sanogo, Moussa K Diawara, Soumaila Traore, Hyacinthe G Kodo, Max-Yvon Mbangui, Marie-Hortense Koudika, Youssouf Diam Sidibé, Johanna Dabernig-Heinz, Christian Kohler, Karsten Becker, Karoline Assig, Direk Limmathurotsakul, Matthias Kohl, Carolina Jimenez, Rupa Kanapathipillai, Janet Ousley, Ivo Steinmetz