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Bonglaisin JN, Kunsoan NB, Bonny P, Matchawe C, Tata BN, Nkeunen G, Mbofung CM. Geophagia: Benefits and potential toxicity to human—A review. Front Public Health 2022; 10:893831. [PMID: 35958861 PMCID: PMC9360771 DOI: 10.3389/fpubh.2022.893831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Geophagy is the habit of consuming clay soil such as chalk or kaolin. Though it is globally practiced, the safety of those involved is yet to be fully established. It is thought to be highly prevalent in pregnant women because of its antinausea or therapeutic effects. This practice is also thought to be provoked by some nutritional needs, but in modern society its etiology is obscure. The mineralogical and chemical compositions of clay may vary from one region to another and even in all form of rocks clay constitutes. Published articles in geophagy indicate lack of adequate investigations into the toxicity of geophagy, though it is globally practiced and more prevalent in Africa (as a continent) or in Africans migrants. Some studies have helped to identify some minerals that are toxic to human if ingested. In most cases, the potential toxicity emphasized by these studies is based on the detection of the presence of these nuisance elements in the geophagic materials. Scientifically, a lot has been done in the light of detection of toxic matter, but more investigations on metabolic studies are still necessary. The variability of clay content with respect to source motivated this review on geophagy and its potential toxicity to human. This review is aimed at bringing out findings that would enable a better understanding of the toxicity potential of geophagy across context and taxa.
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Affiliation(s)
- Julius Nsawir Bonglaisin
- Center for Food and Nutrition Research, Institute of Medical Research and Studies of Medicinal Plants (IMPM), Yaoundé, Cameroon
- *Correspondence: Julius Nsawir Bonglaisin
| | - Noella Bajia Kunsoan
- Centre for Transport and Logistics, “Sapienza” University of Rome, Rome, Italy
- Center for Research in Neurobiology, “Sapienza” University of Rome, Rome, Italy
| | - Patrice Bonny
- Center for Food and Nutrition Research, Institute of Medical Research and Studies of Medicinal Plants (IMPM), Yaoundé, Cameroon
| | - Chelea Matchawe
- Center for Food and Nutrition Research, Institute of Medical Research and Studies of Medicinal Plants (IMPM), Yaoundé, Cameroon
| | - Bridget Ndakoh Tata
- Center for Food and Nutrition Research, Institute of Medical Research and Studies of Medicinal Plants (IMPM), Yaoundé, Cameroon
| | - Gerard Nkeunen
- Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
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Geophagic Materials Characterization and Potential Impact on Human Health: The Case Study of Maputo City (Mozambique). APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12104832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to characterize and estimate risk assessment associated with geophagic materials consumption in Maputo city (Mozambique). Samples were collected in extraction mines, unprepared and prepared ones, and in Maputo markets. Fractions < 2 mm (total consumed material) and <63 μm were analyzed to determine pH, EC, OM, chemical composition (XRF), and mineral phases present (XRD). The results revealed pH from slightly acidic to slightly alkaline, and electrical conductivity ranging from 13 to 47 μS/cm in mine unprepared and prepared samples, while 264–465 μS/cm in sampled sold in markets. Organic matter content was <2.76%, except in one sample (8.14%), suggesting a potential risk of containing bacteria. Textural analysis revealed that sand-size particles were more representative in all samples (57.2–93.02%). Mineralogical phases identified in the consumed sample were ranked quartz (>60%) > Fe oxides/hidroxides > phyllosilicates (micas and kaolinite) > feldspars, suggesting a risk of dental enamel damage and perforation of the sigmoid colon. The chemical concentration of some elements was higher than recommended daily dose, suggesting a potential risk. However, geophagic materials’ chemical composition does not pose a carcinogenic risk.
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Gevera PK, Mouri H. Geochemical and mineralogical composition of geophagic materials from Baringo town, Kenyan Rift Valley and their possible health effects on the consumers. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:4831-4846. [PMID: 34041654 DOI: 10.1007/s10653-021-00960-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
Consumption of geophagic materials can be detrimental to human health. These materials, which are harvested from the natural environment, can contain high concentrations of potentially harmful elements and minerals. In this study, mineralogical and geochemical investigation of geophagic rock materials consumed by the local population in Baringo town, in Kenya, was conducted to assess its possible health effects. Twelve representative samples were purchased from an open market in Baringo town for this investigation. Optical and scanning electron microscope as well as X-ray diffractometer was used to determine the mineralogy as well as the morphology of the minerals present in the studied samples. The material is composed of about 10 to 20% coarse to very coarse (0.38-3.00 mm) and semi-rounded to angular crystals of quartz, feldspars, and amphiboles, together with lithic fragments occurring in a fine-grained matrix. X-ray fluorescence and inductively coupled plasma mass spectrometry were used to determine the major and trace elements composition, respectively. The analyses show that elements such as Si, Fe, Mn, Al, Hg, Cr, Cd, and Pb are particularly above their recommended daily allowances. This study assumes 100% bioavailability of elements in the geophagic materials, in the absence of a bioaccessibility test. Therefore, the consumption of some of the revealed elements, based on this assumption, can be detrimental due to possible short- and/or long-term health effects. From a mineralogical point of view, the presence of feldspar and quartz with Moh's hardness of 6 and 7, respectively, and their coarse and angular morphology may cause damage to the dental enamel and the gastrointestinal tract. From a geochemical point of view, the high concentrations of the revealed chemical elements can have various health effects including, but not limited to neurotoxic effects, which are critical in prenatal exposure, neurodegenerative diseases, and cancer amongst other serious diseases.
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Affiliation(s)
- Patrick Kirita Gevera
- Department of Geology, University of Johannesburg, P.O. Box 524, Johannesburg, Kingsway, 2006, Auckland Park, South Africa.
| | - Hassina Mouri
- Department of Geology, University of Johannesburg, P.O. Box 524, Johannesburg, Kingsway, 2006, Auckland Park, South Africa
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Miller JD, Fitzgerald KG, Smith AL, Young SL. Geophagy among a Cohort of Kenyan Women with Mixed HIV Status: A Longitudinal Analysis. Am J Trop Med Hyg 2020; 101:654-660. [PMID: 31333167 DOI: 10.4269/ajtmh.19-0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Geophagy, the craving and purposive consumption of earth, is commonly reported during pregnancy. To date, most studies of geophagy have been cross-sectional and have not assessed its relationship with HIV infection. Therefore, to concurrently examine proposed etiologies of geophagy, a cohort of 371 women with mixed HIV status from Nyanza region, Kenya were recruited in late pregnancy and interviewed about pica at nine time points, through 21 months postpartum. Nutritional status (hemoglobin concentration and food insecurity), physical health (HIV infection and gastrointestinal distress), and psychosocial health (depression and perceived stress) were also repeatedly assessed. Prevalence of geophagy was greatest during pregnancy and decreased significantly postpartum. In a two-level hierarchical linear model, a one-unit increase in average hemoglobin (g/dL) was associated with a 35% decrease in the odds of geophagy. The adjusted odds ratios (CI) of geophagy were 3.98 (2.99, 5.29), 2.54 (1.13, 5.69), and 1.68 (1.15, 2.44) times higher if a woman was pregnant, reported diarrhea in the prior 24 hours, or was HIV positive, respectively. The adjusted odds ratio of geophagy was 1.61 (1.06, 2.45) times higher if a woman reported geophagy during childhood. Our results lend greatest plausibility to the protection hypothesis (i.e., that geophagy occurs in response to compromised immunity and/or infection). Given the high prevalence of geophagy, clinicians should regularly screen for the behavior and measure inflammatory biomarkers before treating geophagy with iron supplements, which can exacerbate some infections.
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Affiliation(s)
- Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois
| | | | - Abigail L Smith
- Department of Statistics, Northwestern University, Evanston, Illinois
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois
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Yamamoto SS, Premji SS, Nyanza EC, Jahanpour O. Investigating the association between stress. Anxiety and geophagy among pregnant women in mwanza, Tanzania. Appetite 2019; 142:104328. [PMID: 31238080 DOI: 10.1016/j.appet.2019.104328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 11/05/2018] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
Geophagy, the craving and intentional consumption of soil, is common especially among pregnant women in some low- and middle-income settings. Soils may contain a variety of non-nutritive components such as heavy metals and microbes or substances that interfere with gastrointestinal absorptive processes, posing health risks to pregnant women. Several hypotheses regarding the practice have been proposed but very few have examined the role of maternal stress. The practice of geophagy may help to alleviate stress or anxiety during gestation from perceived dietary or other pregnancy-related concerns. In this study, we evaluated several measures of maternal stress (general anxiety, Pregnancy-Related Anxiety Scores (10-item revised), and Perceived Stress Scores) and other covariates in relation to geophagic behaviour in early pregnancy in 227 women (12-19 weeks gestation) recruited from two hospitals in the Nyamagana district of Mwanza City, Tanzania. Geophagy was reported by 24.7% of the pregnant women. Using LASSO regression, self-reported treatment of nausea or vomiting during pregnancy (adjusted OR = 3.12, 95%CI: 1.43 to 6.83), paternal education level (adjusted OR = 2.79, 95%CI: 1.32 to 5.87 for primary or lower education level), antenatal hospital site (adjusted OR = 3.71, 95%CI: 1.78 to 7.75), prescription drug use prior to pregnancy (adjusted OR = 1.76, 95%CI: 0.87 to 3.56) and general anxiety (feeling worried, tense or anxious in the past four weeks) (adjusted OR = 1.81, 95%CI: 0.88 to 3.72) were associated with geophagic behaviour. Given that relatively little has been done to examine geophagy in relation to the public health risk it may pose to pregnant women, these findings suggest the need for further investigations regarding maternal stress.
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Affiliation(s)
- Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton Clinic Health Academy, 11405-87Ave, Edmonton, Alberta, T6G 1C9, Canada.
| | - Shahirose S Premji
- School of Nursing, Faculty of Health, York University, 313 HNES Building, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
| | - Elias C Nyanza
- Department of Environmental and Occupational Health, School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando Area, Mwanza, Tanzania.
| | - Ola Jahanpour
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, P.O. Box 2240, Tanzania.
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Chung EO, Mattah B, Hickey MD, Salmen CR, Milner EM, Bukusi EA, Brashares JS, Young SL, Fernald LCH, Fiorella KJ. Characteristics of Pica Behavior among Mothers around Lake Victoria, Kenya: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2510. [PMID: 31337101 PMCID: PMC6679355 DOI: 10.3390/ijerph16142510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 11/16/2022]
Abstract
Background: Pica, the craving and purposeful consumption of nonfoods, is poorly understood. We described the prevalence of pica among women on Mfangano Island, Kenya, and examined sociodemographic and health correlates. Methods: Our cross-sectional study included 299 pregnant or postpartum women in 2012. We used a 24-h recall to assess pica, defined as consumption of earth (geophagy), charcoal/ash, or raw starches (amylophagy) and built multivariable logistic regression models to examine sociodemographic and health correlates of pica. Results: Eighty-one women (27.1%) engaged in pica in the previous 24 h, with 59.3% reporting amylophagy and 56.8% reporting geophagy, charcoal, and/or ash consumption. The most common substances consumed were raw cassava (n = 30, 36.6%), odowa, a chalky, soft rock-like earth (n = 21, 25.6%), and soil (n = 17, 20.7%). Geophagy, charcoal, and/or ash consumption was negatively associated with breastfeeding (OR = 0.38, 95% CI: 0.18-0.81), and amylophagy was associated with pregnancy (OR = 4.31, 95% CI: 1.24-14.96). Pica was more common within one of six study regions (OR = 3.64, 95% CI: 1.39-9.51). We found no evidence of an association between food insecurity and pica. Conclusion: Pica was a common behavior among women, and the prevalence underscores the need to uncover its dietary, environmental, and cultural etiologies.
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Affiliation(s)
- Esther O Chung
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435, USA.
| | - Brian Mattah
- Ekialo Kiona Research Dept, Organic Health Response, Mbita, P.O. Box 224-40305, Kenya
| | - Matthew D Hickey
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, UCSF, 1001 Potrero Ave, San Francisco, CA 94110, USA
| | - Charles R Salmen
- Ekialo Kiona Research Dept, Organic Health Response, Mbita, P.O. Box 224-40305, Kenya
- Department of Family Medicine and Community Health, University of Minnesota, 5516 Delaware St SE, Minneapolis, MN 55455, USA
| | - Erin M Milner
- Bureau for Global Health, USAID, Washington, DC 20001, USA
| | - Elizabeth A Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Hospital Road, Nairobi 00100, Kenya
| | - Justin S Brashares
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, 130 Mulford Hall #3114, Berkeley, CA 94720, USA
| | - Sera L Young
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA
| | - Lia C H Fernald
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA 94720-7360, USA
| | - Kathryn J Fiorella
- Master of Public Health Program, Department of Population Medicine and Diagnostic Sciences, Cornell University, S2-004 Shurman Hall, Ithaca, NY 14853, USA
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Miller JD, Collins SM, Omotayo M, Martin SL, Dickin KL, Young SL. Geophagic earths consumed by women in western Kenya contain dangerous levels of lead, arsenic, and iron. Am J Hum Biol 2018; 30:e23130. [PMID: 29722093 DOI: 10.1002/ajhb.23130] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/25/2018] [Accepted: 04/07/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Geophagy is commonly reported by pregnant women and children, yet its causes and consequences remain poorly understood. Therefore, we sought to determine if geophagy could contribute micronutrients and/or be a source of heavy metal exposure by examining the elemental composition of earths consumed in Kakamega, Kenya. METHODS Ten samples of earths commonly consumed during pregnancy were collected by study enumerators and analyzed using inductively coupled plasma-atomic emission spectroscopy. Samples were either collected at markets or from walls of participants' homes, based on where participants reported most commonly sourcing their consumed earths. RESULTS Based on estimated intakes (40 g/day), all samples had lead levels that exceeded the provisional maximum tolerable daily intake, and one sample exceeded the threshold for arsenic. Further, estimated intakes of iron for all samples were at least 8.9 times higher than the established threshold. Elemental concentrations were also compared by the site of sample collection (market vs. household wall); market samples had significantly higher iron concentrations and lower calcium concentrations than wall samples. CONCLUSIONS Geophagic earths in Kakamega may be harmful because of dangerously high levels of lead, arsenic, and iron. The prevalence of geophagy among vulnerable populations underscores the importance of understanding its causes and consequences for accurate public health messaging.
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Affiliation(s)
- Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
| | - Shalean M Collins
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
| | - Moshood Omotayo
- Program in International Nutrition, Cornell University, Ithaca, New York 14850.,Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York 14214
| | - Stephanie L Martin
- Department of Nutrition, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Katherine L Dickin
- Department of Nutritional Sciences, Cornell University, Ithaca, New York 14850
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
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Ivoke N, Ikpor N, Ivoke O, Ekeh F, Ezenwaji N, Odo G, Iyaji F, Onoja U, Eyo J. Geophagy as risk behaviour for gastrointestinal nematode infections among pregnant women attending antenatal clinics in a humid tropical zone of Nigeria. Afr Health Sci 2017; 17:24-31. [PMID: 29026374 DOI: 10.4314/ahs.v17i1.5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Geophagy is wide spread among pregnant women in Ebonyi State, Nigeria. OBJECTIVE The aim of this study was to assess intestinal nematode infections among geophagous pregnant women in Southern Ebonyi State, Nigeria. METHODS Pregnant women were aged 17-45 years at gestational ages of ≥ 14 to 24 weeks on hospital enrolment were sampled. Data on geophagy was collected using structured questionnaire. Gastrointestinal nematode status of the participants was determined by stool analyses. Soil types ingested were examined for intestinal nematode ova / larvae. RESULTS The prevalence of geophagy (46.4%) was associated with socio-demographic characteristics. Ascaris lumbricoides and hookworm were associated with geophagy while Trichuris trichiura and Strongyloides stercoralis had no association. Prevalence of A. lumbricoides, T. trichiura and S. stercoralis differed significantly (p<0.05) between geophagous and non-geophagous women. The soil types consumed had eggs / larvae of A. lumbricoides and T. trichiura. Geophagy is a risk behaviour directly associated with A. lumbricoides, hookworm, T. trichiura, and to a lesser extent S. stercoralis infection among pregnant women. CONCLUSION Sensitization and mass education of pregnant women on the dangers of geophagy is needed. Furthermore, deworming of pregnant women should be integrated into the healthcare delivery system of the State.
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Affiliation(s)
- Njoku Ivoke
- University of Nigeria, Department of Zoology and Environmental Biology
| | - Nnenna Ikpor
- University of Nigeria, Department of Zoology and Environmental Biology
| | - Obinna Ivoke
- Jackson State University, Department of Epidemiology and Biostatistics, School of Public Health
| | - Felicia Ekeh
- University of Nigeria, Department of Zoology and Environmental Biology
| | - Ngozi Ezenwaji
- University of Nigeria, Department of Zoology and Environmental Biology
| | - Gregory Odo
- University of Nigeria, Department of Zoology and Environmental Biology
| | - Florence Iyaji
- Kogi State University, Department of Biological Sciences
| | - Uwakwe Onoja
- University of Nigeria, Department of Home Science, Nutrition and Dietetics, Faculty of Agriculture
| | - Joseph Eyo
- University of Nigeria, Department of Zoology and Environmental Biology
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Huebl L, Leick S, Guettl L, Akello G, Kutalek R. Geophagy in Northern Uganda: Perspectives from Consumers and Clinicians. Am J Trop Med Hyg 2016; 95:1440-1449. [PMID: 27698274 DOI: 10.4269/ajtmh.15-0579] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 08/08/2016] [Indexed: 12/23/2022] Open
Abstract
The etiology and health consequences of geophagy are still poorly understood. The consumed soil, individual motives, consumption habits, and the clinical perspective of geophagy in northern Uganda were examined. A total of 50 semistructured interviews (17 pregnant, eight nonpregnant women, 10 men, and 15 health-care professionals) were conducted. Our results suggest that geophagy is not limited to pregnancy and can also be found among nonpregnant women and men. During gestation, excessive amounts of various soil types are consumed and can replace food at times. Nonpregnant women and men consume less soil and stick to one type. When pregnant, craving and alleviating gastrointestinal upset are the main motives. In men, the main reasons for geophagy were craving, hypersalivation, and natural stimulants. If soil is craved, it can show similarities to a dependency syndrome. When picked up in childhood, geophagy is more likely to be continued throughout life. The consumption habits differ and thereby vary in their possible implications on health. Our findings suggest that men should be included in further studies. Especially nurses from the antenatal care are exposed to geophagists; however, no national guidelines exist for geophagy. Further research is necessary to create guidelines to be included in medical training and practice.
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Affiliation(s)
- Lena Huebl
- Unit Ethnomedicine and International Health, Department of General Practice and Family Medicine, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Stephan Leick
- Unit Ethnomedicine and International Health, Department of General Practice and Family Medicine, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Lukas Guettl
- Unit Ethnomedicine and International Health, Department of General Practice and Family Medicine, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Grace Akello
- Department of Mental Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Ruth Kutalek
- Unit Ethnomedicine and International Health, Department of General Practice and Family Medicine, Center of Public Health, Medical University of Vienna, Vienna, Austria.
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Ngole-Jeme VM, Ekosse GIE. A Comparative Analyses of Granulometry, Mineral Composition and Major and Trace Element Concentrations in Soils Commonly Ingested by Humans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:8933-55. [PMID: 26264010 PMCID: PMC4555257 DOI: 10.3390/ijerph120808933] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 11/16/2022]
Abstract
This study compared the granulometric properties, mineralogical composition and concentrations of major and trace element oxides of commonly ingested soils (geophagic soil) collected from different countries with a view of understanding how varied they may be in these properties and to understand the possible health implications of ingesting them. Soil samples were collected from three different countries (South Africa, Swaziland and Democratic Republic of Congo (DRC)) and their granulometric properties, concentrations of major and trace element oxides as well as mineralogical composition determined. Differences were observed in the granulometric properties of geophagic soil from the three different countries with most of them having <20% clay content. The soils also showed varied degrees of weathering with values of Chemical Index of Alteration (CIA) and Chemical Index of Weathering (CIW) being between 60% and 99.9% respectively. The mineral assemblages of the soils from South Africa and Swaziland were dominated by the primary minerals quartz and feldspar whereas soils from DRC had more of kaolinite, a secondary mineral than primary minerals. Soils from DRC were associated with silt, clay, Al2O3, and CIA unlike most samples from South Africa which were associated with SiO2, sand, K2O, CaO, and MgO. The soils from Swaziland were closely associated with silt, H2O and Fe2O3(t). These associations reflect the mineralogy of the samples. These soils are not likely to serve as nutrient supplements because of the low concentrations of the nutrient elements contained. The coarse texture of the samples may also result in dental destruction during mastication. Sieving of the soils before ingestion to remove coarse particles is recommended to reduce the potential health threat associated with the ingestion of coarse-textured soils.
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Affiliation(s)
- Veronica M Ngole-Jeme
- Department of Crop Science, Faculty of Agriculture, Science and Technology, North West University, Private Bag X2046, Mmabatho 2735, South Africa.
| | - Georges-Ivo E Ekosse
- Directorate of Research and Innovation, University of Venda, Private Bag X5050, Thohoyandou, Limpopo Province 0950, South Africa.
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Nyambedha EO, Sundaram N, Schaetti C, Akeyo L, Chaignat CL, Hutubessy R, Weiss MG. Distinguishing social and cultural features of cholera in urban and rural areas of Western Kenya: Implications for public health. Glob Public Health 2013; 8:534-51. [PMID: 23672503 PMCID: PMC6176767 DOI: 10.1080/17441692.2013.787107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Urban and rural areas have distinctive health problems, which require consideration. To examine sociocultural features of cholera and its community context, a semi-structured explanatory model interview based on vignettes depicting typical clinical features of cholera was used to interview 379 urban and rural respondents in Western Kenya. Findings included common and distinctive urban and rural ideas about cholera, and its prevention and treatment. The three most commonly perceived causes among urban and rural respondents collectively were drinking contaminated water, living in a dirty environment and lacking latrines. However, a dirty environment and flies were more prominently perceived causes among urban respondents. Rural respondents were less likely to identify additional symptoms and more likely to identify biomedically irrelevant perceived causes of cholera. Oral rehydration therapy was the most frequently reported home treatment. Health facilities were recommended unanimously at both sites. For prevention, rural respondents were more likely to suggest medicines, and urban respondents were more likely to suggest health education and clean food. Findings indicate community priority, demand for and potential effectiveness of enhanced efforts to control cholera in Western Kenya, and they suggest strategies that are particularly well suited for control of cholera in urban and rural areas.
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Abstract
INTRODUCTION Geophagy is a form of pica characterized by craving and eating of soil. The main materials ingested include anthill soils and soft stone. In this review, our objectives were to study the prevalence of geophagy in pregnancy (GiP), establish the risk factors for GiP, assess the effects of GiP on pregnancy outcomes, and recommend possible interventions for reducing GiP. PREVALENCE Geophagy among pregnant women is common in many cultures. In some African countries, GiP prevalence of up to 84% has been observed. In Nigeria, the most populous country in Africa, the prevalence of GiP is estimated at 50%. The practice has been associated with religious practice, culture, and famine. RISKS It is postulated that GiP is due to micronutrient deficiencies, cultural influences, and gastrointestinal upsets. Despite their potential to supply micronutrients, soils interfere with bioavailability of micronutrients leading to micronutrient deficiency and can also act as a pathway for ingestion of geohelminths and heavy metals, putting woman and fetus at risk. GAPS: Despite its association with anemia, pregnancy, and micronutrients, many antenatal care guidelines or National guidelines on micronutrient deficiency control are silent on GiP. The guidelines generally recommend iron supplementation and deworming of pregnant women as anemia control measures. However, not all women seek antenatal services; hence, there is need for more innovative ways of addressing micronutrient deficiencies in pregnancy. RECOMMENDATIONS It is imperative to enquire whether pregnant women are geophagous and discourage geophagy, strengthen and expand the existing supplementation programs, and mandate flour fortification to enhance population-wide iron supply and safer pregnancies. TARGET AUDIENCE Obstetricians & Gynecologists and Family Physicians. LEARNING OBJECTIVES After completing this CME activity, physicians should be better able to analyze the prevalence of GiP, identify the risk factors for GiP, and assess the effects of GiP on pregnancy outcomes. In addition to propose remedial interventions for reducing GiP.
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Kutalek R, Wewalka G, Gundacker C, Auer H, Wilson J, Haluza D, Huhulescu S, Hillier S, Sager M, Prinz A. Geophagy and potential health implications: geohelminths, microbes and heavy metals. Trans R Soc Trop Med Hyg 2010; 104:787-95. [PMID: 20889178 DOI: 10.1016/j.trstmh.2010.09.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 09/01/2010] [Accepted: 09/01/2010] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ruth Kutalek
- Medical University of Vienna, Center for Public Health, Department of General Practice and Family Medicine, Unit Ethnomedicine and International Health, Waehringerstrasse 25, 1090 Vienna, Austria.
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Luoba AI, Geissler PW, Estambale B, Ouma JH, Magnussen P, Alusala D, Ayah R, Mwaniki D, Friis H. Geophagy among pregnant and lactating women in Bondo District, western Kenya. Trans R Soc Trop Med Hyg 2005; 98:734-41. [PMID: 15485704 DOI: 10.1016/j.trstmh.2004.01.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2003] [Revised: 01/15/2004] [Accepted: 01/15/2004] [Indexed: 11/26/2022] Open
Abstract
Geophagy was studied among 827 pregnant women in western Kenya, during and after pregnancy. The women were recruited at a gestational age of 14-24 weeks and followed-up to 6 months post-partum. The median age (range) of the women was 23 years and median parity 2. At recruitment, 378 were eating earth, of which most (65%) reported earth-eating before pregnancy. The preferred type of earth eaten was soft stone, known locally as odowa (54.2%) and earth from termite mounds (42.8%). The prevalence remained high during pregnancy, and then declined to 34.5% and 29.6% at 3 and 6 months post-partum respectively (P < 0.001). The mean daily earth intake was 44.5 g during pregnancy, which declined to 25.5 g during lactation (P < 0.001). A random sample of 204 stools was collected from the women and analysed for silica content as a tracer for earth-eating. The mean silica content was 2.1% of the dry weight of stool. Geophagous women had a higher mean silica content than the non-geophagous ones (3.1% vs. 1.4%, P < 0.001). Faecal silica and reported geophagy were strongly correlated (P < 0.001).
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Affiliation(s)
- Alfred I Luoba
- Divison of Vector-Borne Diseases, Ministry of Health, Kisumu, Kenya
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15
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Luoba AI, Wenzel Geissler P, Estambale B, Ouma JH, Alusala D, Ayah R, Mwaniki D, Magnussen P, Friis H. Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya. Trop Med Int Health 2005; 10:220-7. [PMID: 15730505 DOI: 10.1111/j.1365-3156.2004.01380.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We conducted a longitudinal study among 827 pregnant women in Nyanza Province, western Kenya, to determine the effect of earth-eating on geohelminth reinfection after treatment. The women were recruited at a gestational age of 14-24 weeks (median: 17) and followed up to 6 months postpartum. The median age was 23 (range: 14-47) years, the median parity 2 (range: 0-11). After deworming with mebendazole (500 mg, single dose) of those found infected at 32 weeks gestation, 700 women were uninfected with Ascaris lumbricoides, 670 with Trichuris trichiura and 479 with hookworm. At delivery, 11.2%, 4.6% and 3.8% of these women were reinfected with hookworm, T. trichiura and A. lumbricoides respectively. The reinfection rate for hookworm was 14.8%, for T. trichiura 6.65, and for A. lumbricoides 5.2% at 3 months postpartum, and 16.0, 5.9 and 9.4% at 6 months postpartum. There was a significant difference in hookworm intensity at delivery between geophagous and non-geophagous women (P=0.03). Women who ate termite mound earth were more often and more intensely infected with hookworm at delivery than those eating other types of earth (P=0.07 and P=0.02 respectively). There were significant differences in the prevalence of A. lumbricoides between geophagous and non-geophagous women at 3 (P=0.001) and at 6 months postpartum (P=0.001). Women who ate termite mound earth had a higher prevalence of A. lumbricoides, compared with those eating other kinds of earth, at delivery (P=0.02), 3 months postpartum (P=0.001) and at 6 months postpartum (P=0.001). The intensity of infections with T. trichiura at 6 months postpartum was significantly different between geophagous and non-geophagous women (P=0.005). Our study shows that geophagy is associated with A. lumbricoides reinfection among pregnant and lactating women and that intensities built up more rapidly among geophagous women. Geophagy might be associated with reinfection with hookworm and T. trichiura, although these results were less unequivocal. These findings call for increased emphasis, in antenatal care, on the potential risks of earth-eating, and for deworming of women after delivery.
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Affiliation(s)
- Alfred I Luoba
- Division of Vector-borne Diseases, Ministry of Health, Kisumu, Kenya.
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16
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Olsen A, Nawiri J, Friis H. The impact of iron supplementation on reinfection with intestinal helminths and Schistosoma mansoni in western Kenya. Trans R Soc Trop Med Hyg 2000; 94:493-9. [PMID: 11132373 DOI: 10.1016/s0035-9203(00)90063-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A randomized, placebo-controlled, double-blind trial was carried out in 1994-96 among 231 children and 181 adults in order to determine the effects of iron on reinfection rates and intensities of hookworm, Ascaris lumbricoides, Trichuris trichiura and Schistosoma mansoni. Adults given 60 mg elemental iron twice-weekly for 12 months had significantly lower reinfection rates of A. lumbricoides (16.7% vs 31.9%, P = 0.046), T. trichiura (6.9% vs 20.6%, P = 0.03) and S. mansoni (38.3% vs 61.8%, P = 0.008) compared to adults given placebo. In contrast, adults allocated to iron had a significantly higher reinfection rate of hookworm at the 4-month examination (11.1% vs 0%, P = 0.009), but the difference was not significant at 8- and 12-month follow-up examinations. Iron supplementation had no effect on reinfection intensities in adults. Surprisingly, iron supplementation had no effect on either reinfection rates or intensities in children. Multiple logistic regression analyses controlling for baseline infection status confirmed the effect in adults of iron on A. lumbricoides, T. trichiura and S. mansoni reinfection rates. The effect is suggested to be due to reduced risk behaviour, to improved immune function or to unfavourable host gut conditions caused by an increased oxidative stress. In each case, the lack of effect in children remains to be explained. In contrast, iron supplementation apparently was short-lived in favour of hookworm infection, an effect that needs further clarification. The findings suggest that iron supplementation has a role to play in helminth control programmes and that intraluminal factors may contribute to the regulation of some helminth infections.
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Affiliation(s)
- A Olsen
- Danish Bilharziasis Laboratory, Jaegersborg Allé 1 D, DK-2920 Charlottenlund, Denmark.
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