title: Seroepidemiology of melioidosis in children from a remote region of Papua New Guinea.
abstract: BACKGROUND
  The Balimo region in Papua New Guinea has previously been identified as melioidosis-endemic with a predilection for children. Where health resources are scarce, seroepidemiology can be used to assess exposure to Burkholderia pseudomallei and therefore risk of acquiring melioidosis.
  
  
  METHODS
  Logistic regression was used to determine associations between indirect haemagglutination assay (IHA) seroreactivity with environmental and demographic/cultural factors to aid in determining risk factors associated with exposure to B. pseudomallei in children.
  
  
  RESULTS
  Of the 968 participants, 92.9% (899/968) were children, representing the majority of the community school population in the immediate Balimo region. Of these, 24.6% (221/899) were seropositive. Bathing in the lagoon (OR=2.679), drinking from the well or lagoon (OR=1.474), and being a member of the Siboko (OR=1.914) or Wagumisi (OR=1.942) clans were significantly associated with seropositivity. In the multivariate analysis, drinking from a well or lagoon (OR=1.713), and the Siboko (OR=2.341) and Wabadala (OR=2.022) clans were associated with seropositivity.
  
  
  CONCLUSIONS
  This study in children supports observations that interactions with groundwater in this region are risk factors in acquiring melioidosis. Public health measures intended to limit this exposure may help reduce the risk of acquiring melioidosis in this remote community. Associations with clan structure may provide more cultural specific insights, however this requires further elucidation.
authors.affiliation: College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, 4811, Australia.
authors.forename: Tanya R
authors.initials: TR
authors.lastname: Diefenbach-Elstob
authors.affiliation: Centre for Biosecurity in Tropical Infectious Diseases, College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, Queensland, 4878, Australia.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Graves
authors.affiliation: Centre for Biosecurity in Tropical Infectious Diseases, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, 4811, Australia.
authors.forename: Graham W
authors.initials: GW
authors.lastname: Burgess
authors.affiliation: Balimo Health Centre, Balimo, Western Province, Papua New Guinea.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Pelowa
authors.affiliation: Centre for Biosecurity in Tropical Infectious Diseases, College of Public Health, Medical & Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, 4811, Australia jeffrey.warner@jcu.edu.au.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Warner
mesh_terms: D000293:Adolescent; D001493:Bathing Beaches; D016957:Burkholderia pseudomallei / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008554:Melioidosis / Q000453:epidemiology* / Q000276:immunology; D010219:Papua New Guinea / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D014881:Water Supply
keywords: Burkholderia Pseudomallei; Indirect haemagglutination assay; Melioidosis; Papua New Guinea; Seroepidemiology