Pentastomiasis: Public Health Strategies

Transmission

Epidemiology

Pentastomes are a world-wide phenomenon, but are mainly found in the tropics and subtropics (equatorial Africa, the Middle East, and southeast Asia.) The distribution of pentastomes is also determined by available areas of water and poor sanitation.

More specifically,

  • Armillifer armillatus is found in West and Central Africa, (and sometimes East and southern Africa.)
  • Linguatula serrata is found in Europe, Near and Middle East, and Brazil.
  • Armillifer (porocephalus) moniliformis lives in India, Malaysia, southeast Asia, China, Indonesia, and Philippines.
  • On the rare occasions it is seen, Armillifer grandis is found in Central Africa.
  • Porocephalus crotali, which also rarely infects man, is in North and South America.
  • R. hemidactyli can cause subcutaneous infections in Southeast Asia, which is referred to as Creeping Disease.

It is difficult to ascertain the exact prevalence of pentastomiasis due to its asymptomatic nature. We can assume that it is more widespread than the sum of cases in published records.

A radiologic screening by Prathap et al. found pentastomiasis in 45.4% of 30 consecutive autopsies of Malaysian aborigines, which is thought to be the highest prevalence in a population. It was more common in males than females, and appeared to contribute to no deaths. (13)

Other radiologic screenings in Kinshasa, Zaire, and Ibadan, Nigeria showed population prevalence of .04% and 1.4%, respectively. (Van Wymeersch and Wanson, 1954 (2), and (8))

Prevention

Prevention of pentastomiasis includes adequate cooking of snakes before eating them, washing hands after handling snakes or harvesting skins, and boiling water before drinking. In southeast Asia, infection would be halted by refusing to small, live lizards (a "remedy" for certain respiratory diseases.)

Control and Management in Public Health

Pentastomiasis is not a main health concern. It does not result in widespread morbidity, much less mortality. It is most commonly discovered by autopsy in people who died from unrelated causes.

Research Possibilities

Because certain species of pentastomes can dwell in and move through the tissues of their definitive or secondary hosts and elicit little or no inflammatory reaction, research in this field could revolutionize our understanding of anti-graft immune responses or general immune system function.

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