{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:55:19Z","timestamp":1792598119172,"version":"4.5.0"},"reference-count":3,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wellcome Trust Research Unit","award":["315982\/Z\/24\/Z"],"award-info":[{"award-number":["315982\/Z\/24\/Z"]}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns3:p>\n                    Background Melioidosis, caused by\n                    <ns3:italic>Burkholderia pseudomallei<\/ns3:italic>\n                    , is a severe tropical infection with diverse clinical manifestations and high mortality if untreated. Although endemic in Southeast Asia and northern Australia, its burden is increasingly recognized in South Asia, where the disease remains underdiagnosed and is frequently misclassified as tuberculosis or other infections. This review synthesizes the contemporary scientific evidence and expert consensus emerging from the 4th South Asian Melioidosis Congress held in Guwahati, Assam, India, in November 2025. Methods We conducted an integrated narrative synthesis of the scientific content presented at the Congress, including plenary lectures, oral and poster presentations, panel discussions, and case-based deliberations. Topics encompassed epidemiology, clinical manifestations, laboratory diagnostics, genomics, treatment strategies, outbreak investigations, antimicrobial resistance, and One Health perspectives across South and Southeast Asia. Results The Congress highlighted expanding geographic recognition of melioidosis across India and neighbouring countries, with reported cases likely representing only a small fraction of the true disease burden. Clinical discussions emphasized marked heterogeneity in presentation and strong associations with diabetes mellitus, environmental exposure, and the monsoon season. Advances in diagnostics included broader implementation of MALDI-TOF mass spectrometry, molecular assays, and rapid diagnostic tests, although significant gaps remain in laboratory capacity, surveillance, and clinical recognition. Genomic investigations demonstrated substantial strain diversity while identifying conserved virulence determinants that may support surveillance and outbreak investigations. Participants also underscored the importance of multidisciplinary collaboration, standardized diagnostic practices, and regional data sharing to improve case detection and patient outcomes. Conclusions Melioidosis remains an underrecognized but increasingly important public health challenge in South Asia. Strengthening surveillance systems, expanding diagnostic capacity, improving clinician awareness, fostering regional laboratory networks, and adopting coordinated One Health strategies are essential to reduce morbidity and mortality. The Congress also reinforced the need for sustained advocacy toward recognition of melioidosis as a neglected tropical disease.\n                  <\/ns3:p>","DOI":"10.12688\/wellcomeopenres.27378.1","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:54:08Z","timestamp":1787309648000},"page":"535","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Melioidosis in South Asia: Scientific Advances, Regional Challenges and One Health Perspectives\u2014An Integrated Research Synthesis from the 4th South Asian Melioidosis Congress"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0402-1143","authenticated-orcid":false,"given":"Chiranjay","family":"Mukhopadhyay","sequence":"first","affiliation":[{"name":"Department of Microbiology Manipal Karnataka 576104 Kasturba Medical College Manipal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chimanjita","family":"Phukan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Dibrugarh Assam 786002 Assam Medical College and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurav Jyoti","family":"Patgiri","sequence":"additional","affiliation":[{"name":"Dibrugarh Assam 786001 ICMR - National Institute of Health Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Division of Communicable Diseases New Delhi Delhi 110029 Indian Council of Medical Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8878-8837","authenticated-orcid":false,"given":"Bart J","family":"Currie","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division Darwin Northern Territory 0810 Menzies School of Health Research and Charles Darwin University"},{"name":"Division of Medicine Casuarina Northern Territory NT 0810 Royal Darwin Hospital Department of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9189-7244","authenticated-orcid":false,"given":"David","family":"AB Dance","sequence":"additional","affiliation":[{"name":"London England WC1E 7HT London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases"},{"name":"Vientiane 01000 Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"15008","DOI":"10.1038\/nmicrobiol.2015.8","article-title":"Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis.","volume":"1","author":"D Limmathurotsakul","year":"2016 Jan 1","journal-title":"Nat Microbiol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"517-523","DOI":"10.1097\/QCO.0000000000000869","article-title":"Melioidosis and Burkholderia pseudomallei: progress in epidemiology, diagnosis, treatment and vaccination.","volume":"35","author":"B Currie","year":"2022 Dec 1","journal-title":"Curr Opin Infect Dis."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"155-169","DOI":"10.1038\/s41579-023-00972-5","article-title":"Burkholderia pseudomallei and melioidosis.","volume":"22","author":"E Meumann","year":"2024 Mar","journal-title":"Nat Rev Microbiol."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-535\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-535\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-535\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:24:08Z","timestamp":1792596248000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-535\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":3,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.27378.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.30133.r171292","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.30133.r165505","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.30133.r171292","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.30133.r165505","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-535\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.30133.r165505, Sylvia Chieng, Universiti Kebangsaan Malaysia, Bangi, 05 Sep 2026, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-535\/v1#referee-response-165505","order":0,"name":"referee-response-165505","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.30133.r171292, Patpong Rongkard, Imperial College London, London, 15 Oct 2026, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-535\/v1#referee-response-171292","order":1,"name":"referee-response-171292","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome Trust Research Unit (LOMWRU) (Grant No. 315982\/Z\/24\/Z). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}