Summary:

The Darwin Prospective Melioidosis Study aims to understand the clinical and microbiological aspects of melioidosis in the Top End and collaborate with colleagues globally through the International Melioidosis Network. This information is then used to lessen the burden of the disease, through earlier diagnosis, improved treatment and public health prevention messages. Over the 31 years the study has been running there has been a large decrease in the mortality rate from melioidosis, from over 30 per cent initially to now under 5 per cent.

Following very heavy wet seasons in 2009-2012, there was a dramatic rise in melioidosis cases in tropical Northern Australia. Between 1 October 2009 and 30 September 2010, a then record number of 91 confirmed melioidosis cases were recorded. Of these, 11 proved fatal. This compares with a median of 27 cases per 12-month period over the previous 20 years. Subsequently, there were 64 cases in 2010/2011 and 97 cases in 2011/2012. In the dryer years since 2013, yearly case numbers have varied between 42 and 70.

The rise in the proportion of cases from the Darwin urban region has been particularly striking and the reasons for this are considered to be a combination of weather patterns, urban construction activity (with disturbance of soil) and increased numbers of people with risk factors for melioidosis living in Darwin and surrounds.

In addition, the genetic diversity of the Burkholderia pseudomallei (B. pseudomallei) strains from the various locations over recent years is being determined, with a particular focus on those strains that originate from higher risk Darwin suburbs. Comparisons with bacterial genotypes from overseas supports the hypothesis that B. pseudomallei originated in Australia and subsequently spread to Southeast Asia and then to Africa and most recently to the Americas.

The Darwin Melioidosis Treatment Guidelines have been adopted internationally and the findings from 30+ years of Menzies studies have resulted in 258 peer-reviewed journal publications covering diverse aspects of the disease (melioidosis) and its pathogen (B. pseudomallei). Menzies will be hosting the 10th World Melioidosis Congress in Darwin in 2023.

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The study commenced in 1989 and is ongoing.