Estimation of Seropositivity to Burkholderia pseudomallei Among Family Members of Melioidosis Patients by Indirect Hemagglutination Assay
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Background: Melioidosis, caused by Burkholderia pseudomallei , is a significant public health concern in tropical regions. This study aimed to identify predictors of high IHA titers among family members of culture-proven melioidosis patients, providing valuable insights into its epidemiology. Methods: A cross-sectional study was conducted at Kasturba Hospital, Manipal, India from June 2020 to December 2022; enrolled adult family members of melioidosis patients without recent signs of infection or antibiotic exposure. Blood samples were tested for anti- B. pseudomallei antibodies using the indirect hemagglutination (IHA) assay. Socio-demographic and lifestyle data were collected via detailed questionnaires. Logistic regression identified predictors of seropositive individuals (IHA titer > 40), with results presented as prevalence odds ratios (POR) and 95% confidence intervals (CI). Results: Among the 246 participants (mean age 46.1 years), the seroprevalence rate was 8.13%. Significant predictors of high IHA titers included older age (POR: 1.03 per year; CI: 0.995-1.08; p=0.092), female gender (POR: 0.186; CI: 0.0588-0.500; p=0.001), occupation as a farmer (POR: 3.27; CI: 1.30-8.69; p=0.019), and activities like walking in fields (POR: 7.20; CI: 2.27-34.3; p = 0.002) or rice fields (POR: 3.85; CI: 1.31-12.1; p=0.010). Conversely, smoking (POR: 0.274; CI: 0.0955-0.723; p<0.001) and washing clothes in the river (POR: 0.118; CI: 0.0321-0.380; p=0.001) showed a decreased likelihood of high IHA titers. Conclusions: These findings highlight key demographic and lifestyle factors associated with high IHA titers among family members of melioidosis patients, guiding targeted public health interventions to reduce B. pseudomallei exposure. Trial registered: This study has been registered in Clinical Trial Registry India; CTRI registration number: CTRI/2020/06/025663; CTRI registration date: 02/06/2020.
