Diabetes
Trends and Risk of Melioidosis in Diabetic Patients: A Population-Based Study Using Taiwan’s National Health Insurance Database Chia-Chi Chien* Chia-Chi Chien Fu-Huang Lin Chien-An Sun Yu-Ching Chou
Trends and Risk of Melioidosis in Diabetic Patients: A Population-Based Study Using Taiwan’s National Health Insurance Database
Chia-Chi Chien1, Fu-Huang Lin1, Chien-An Sun2, Yu-Ching Chou1*
1School of Public Health, National Defense Medical Center, Taipei, 2Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
*Corresponding author: trishow@mail.ndmctsgh.edu.tw
Background:Melioidosis, caused by Burkholderia pseudomallei, is a Category IV notifiable disease in Taiwan with high mortality rates, reaching 90% without treatment and 10–50% with treatment. Predominantly found in tropical regions, it is closely linked to diabetes, with about 50% of patients affected. Data on its incidence among diabetic patients in Taiwan is limited. This study uses the National Health Insurance Research Database to analyze melioidosis incidence in diabetic patients and the broader Taiwanese population.
Methods: From 2000 to 2013, trends and risks of melioidosis in diabetic patients were analyzed using Taiwan’s National Health Insurance Database. Eligible cases were identified, and chi-square tests were employed to evaluate differences in the incidence rates of melioidosis across sex, age groups, and time periods. Additionally, long-term changes in the incidence rates of melioidosis among diabetic patients were assessed using linear trend analysis to reveal potential trends and associated risk factors.
Results: In men, diabetes incidence dropped from 1.43 to 0.34 per 1,000 individuals between 2000 and 2013, and in women, from 1.59 to 0.33. Overall, it declined from 3.02 to 0.67 per 1,000. In contrast, melioidosis incidence rose from 0.92 to 1.60 per million, with an annual increase of 4.3% in women and 0.9% in men. Among diabetic patients, melioidosis incidence per 10,000 increased across age groups (30–39, 40–49, 50–59, ≥60 years) from 0.89 to 4.04 (P < 0.001), and was higher in females (3.02) than males (1.91) (P = 0.012).
Conclusion:
In the past 14 years, the incidence of melioidosis among diabetic patients have shown significant trends. Utilizing big data from the Taiwan National Health Insurance Research Database, our findings suggest a steadily increasing incidence of melioidosis in this population. Therefore, further studies are required to confirm the association between diabetes and melioidosis and to explore potential preventive strategies.
Keywords: Melioidosis、Diabetes mellitus