Influence of physico-chemistry and mineralogy on the occurrence of geohelminths in geophagic soils from selected communities in the Eastern Cape, South Africa, and their possible implication on human health

Current status of research and gaps in knowledge of geophagic practices in Africa

This article synthesises current knowledge and identifies research gaps on the still intriguing aspects of the subject of geophagy as practised in Africa. Despite the voluminous research literature that exists on the subject, geophagy in Africa is still a largely misunderstood phenomenon. Although the practice is not confined to any particular age group, race, gender, or geographical region, in Africa it is most commonly recorded among pregnant women and children. Till now, the precise aetiology of geophagy remains obscure; but the practice is thought to have both beneficial effects such as having a role as a nutrient supplement, as well as several demerits. An updated critical review of human geophagy in Africa - with a section on (other) animal geophagy -, highlights several aspects of the practice that need further research. A comprehensive bibliography is assembled, comprising some of the more pertinent and recently published papers (mostly post-dating the year 2005), as well as older seminal works, providing a baseline and robust framework for aiding the search process of Medical Geology researchers and those from allied fields wanting to explore the still poorly understood aspects of geophagy in Africa.

Socio-medical studies of individuals self-treating with helminths provide insight into clinical trial design for assessing helminth therapy

The virtually complete loss of intestinal worms, known as helminths, from Western society has resulted in elimination of a range of helminth-induced morbidities. Unfortunately, that loss has also led to inflammation-associated deficiencies in immune function, ultimately contributing to widespread pandemics of allergies, autoimmunity, and neuropsychiatric disorders. Several socio-medical studies have examined the effects of intentional reworming, or self-treatment with helminths, on a variety of inflammation-related disorders. In this study, the latest results from ongoing socio-medical studies are described. The results point toward two important factors that appear to be overlooked in some if not most clinical trials. Specifically, (a) the method of preparation of the helminth can have a profound effect on its therapeutic efficacy, and (b) variation between individuals in the effective therapeutic dosage apparently covers a 10-fold range, regardless of the helminth used. These results highlight current limits in our understanding of the biology of both hosts and helminths, and suggest that information from self-treatment may be critical for clinical evaluation of the benefits and limits of helminth therapy.

Geophagic Clays from Cameroon: Provenance, Metal Contamination and Health Risk Assessment

This study assessed the mineralogical and geochemical characteristics of geophagic clays sold in some markets in Cameroon to ascertain their provenance, contamination status and human health risk. To achieve this, 40 samples from 13 markets in Cameroon were purchased and analysed using X-ray diffractometry, X-ray fluorescence and laser ablation inductively coupled plasma mass spectrometry for their mineralogy and geochemistry, respectively. The geophagic clays were dominantly made up of kaolinite and quartz. Their chemistry was dominated by SiO₂, Al₂O₃ and LOI with means of 48.76 wt%, 32.12 wt% and 13.93 wt%, respectively. The major, trace and rare earth elements data showed that these geophagic clays were predominantly derived from felsic rocks. The contamination assessment indicated no enrichment of metals from anthropogenic sources, except for Zn in samples from Acacia, Madagascar and Mfoudi markets. The index of geo-accumulation indicated no contamination to moderate contamination of the clays. The non-carcinogenic index values for Fe, Co, Cr, Cu, Ni, Pb and Zn were generally less than 1, suggesting no non-carcinogenic risk exposure to children and adults consuming the geophagic clays from these metals. The carcinogenic risk index (TCR) for Ni and Cr were above 10⁻⁶, which implies that children and adults are vulnerable to minimal carcinogenic health risk. The TCR values from Ni posed the highest risk, especially to children consuming clays from some markets.

Geospatial Modelling and Univariate Analysis of Commensal Rodent-Borne Cestodoses: The Case of Invasive spp. of Rattus and Indigenous Mastomys coucha From South Africa

Poor socio-economic and unsanitary conditions are conducive to commensal rodent infestations, and these conditions are widespread in South Africa. Cestode species of zoonotic interest are highly prevalent in commensal rodents, such as invasive Rattus norvegicus, Rattus rattus, Rattus tanezumi, and indigenous Mastomys coucha, and have been frequently recovered from human stool samples. These cestode species have similar transmission dynamics to traditional soil-transmitted helminths (STHs), which ties them to infections associated with poverty and poor sanitation. Univariate analysis was used in the present study to determine the association between rodent-related factors and cestode prevalence, while ecological niche modelling was used to infer the potential distribution of the cestode species in South Africa. Cestode prevalence was found to be associated with older rodents, but it was not significantly associated with sex, and ectoparasite presence. The predicted occurrence for rodent-borne cestodes predominantly coincided with large human settlements, typically associated with significant anthropogenic changes. In addition, cestode parasite occurrence was predicted to include areas both inland and along the coast. This is possibly related to the commensal behaviour of the rodent hosts. The study highlights the rodent-related factors associated with the prevalence of parasites in the host community, as well as the environmental variables associated with parasite infective stages that influence host exposure. The application of geospatial modelling together with univariate analysis to predict and explain rodent-borne parasite prevalence may be useful to inform management strategies for targeted interventions.

Strongyloides stercoralis Infection at Different Altitudes of the Cusco Region in Peru

Strongyloides stercoralis affects 30-100 million people worldwide. The burden is underestimated because of the paucity of studies, limited geographical areas surveyed, and poor quality of diagnostic tests. This study aimed at determining the epidemiology of strongyloidiasis using sensitive microscopy testing in rural populations living at different altitudes in Cusco, Peru. Data were collected from subjects aged > 3 years living in Quellouno (elevation 2,600 ft) and Limatambo (elevation 8,379 ft) districts. Subjects provided one fresh stool sample and answer a standardized questionnaire. Fresh stool was tested on site using the Baermann's test and agar plate culture. Formalin-preserved stool was tested by rapid sedimentation. Eighty percent (585/715) of eligible subjects consented to participate; after excluding subjects with missing data, 65% (462/715) were included. Fifty-five percentage were female; the median age was 33 years (interquartile range 13-52), and 72% had government health insurance. Half had intestinal parasites, and Strongyloides was the most common (24.5%) followed by Giardia (15.5%), Blastocystis (14.9%), and hookworm (11.5%). The agar plate culture detected more cases of Strongyloides than Baermann's or sedimentation tests. Strongyloides infection was more common at low altitude (26.4%) than at high altitude (18.6%), but the difference was not statistically significant (P = 0.08). Older age, walking barefoot, bathing in rivers/streams, and using municipal sewage were associated with strongyloidiasis. Strongyloides was the most prevalent parasite in the areas studied and was associated with demographic, socioeconomic, and sanitary factors.

A Review of Strongyloides spp. Environmental Sources Worldwide

Strongyloides spp. are parasitic nematodes that are transmitted through the environment and are capable of causing disease. These nematodes affect an estimated 3–300 million humans worldwide. Identifying the environmental reservoirs of Strongyloides spp. is essential for the development of appropriate control strategies. This systematic literature review examined all published studies that identified Strongyloidesstercoralis, Strongyloidesfuelleborni, Strongyloidesfuellebornikellyi, and Strongyloides spp. from an environmental source. Most studies detected the nematode from dog and primate fecal samples. Other environmental sources identified were ruminants, cats, rodents, insects, water, soil, as well as fruit and vegetables. Most studies used microscopy-based identification techniques; however, several employed molecular-based techniques, which have become increasingly popular for the detection of Strongyloides spp. A limitation identified was a lack of studies that comprehensively screened all potential environmental samples in a region. Future research should undertake this holistic screening process to identify which environmental reservoirs pose the greatest significance to human health. Potential controls can be identified through the identification of environmental sources. Understanding where Strongyloides spp. is commonly found within the environment of endemic areas will inform environmental control strategies to reduce this neglected disease.

An analysis of human exposure to trace elements from deliberate soil ingestion and associated health risks

Fifty-seven samples of soils commonly ingested in South Africa, Swaziland, Democratic Republic of Congo (DRC), and Togo were analyzed for the concentrations of arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), lead (Pb), manganese (Mn), nickel (Ni), and zinc (Zn) and their bioaccessibility in the human gastrointestinal tract. Bioaccessibility values were used to calculate daily intake, and hazard quotient of each trace element, and chronic hazard index (CHI) of each sample. Carcinogenic risk associated with As and Ni exposure were also calculated. Mean pseudo-total concentrations of trace elements in all samples were 7.2, 83.3, 77.1, 15.4, 28.6, 24.9, 56.1, 2.8, and 26.5 mg/kg for As, Cr, Mn, Co, Ni, Cu, Zn, Cd, and Pb, respectively. Percent bioaccessibility of Pb (13-49%) and Zn (38-56%) were highest among trace elements studied. Average daily intake values were lower than their respective reference doses for ell elements except for Pb in selected samples. Samples from DRC presented the highest health risks associated with trace element exposure with most of the samples having CHI values between 0.5 and 1.0. Some samples had higher than unacceptable values of carcinogenic risk associated with As and Ni exposure. Results indicate low trace element exposure risk from ingesting most of the soil samples.