pica and Helminthiasis

Pregnancy is a key step for human's reproduction and continuity of generation. Pregnant women are among at risk groups for the infection of soil-transmitted helminths (STHs). STHs are highly prevalent in low- and middle-income countries due to the deprived environmental sanitation and personal hygiene. Eating soil (geophagia) is also commonly practiced by pregnant women, particularly in developing countries. The aim of this study was to determine the prevalence of STHs and geophagia, and to assess associated factors among pregnant women in Jimma, Southwest Ethiopia.. A cross sectional study was conducted among 407 pregnant women attending antenatal care (ANC) at different health facilities located in Jimma Town. Data related to sociodemographic and geophagia practice was collected using a structured questionnaire and STH infections status was determined by using McMaster technique.. A total of 407 pregnant women were included in this study. The overall prevalence of any STHs was 19.7% (80/407). Ascaris lumbricoides was the most prevalent 45(56.2%), followed by Trichuris trichiura 19(23.8%) and hookworms 12(15%). There were 4(5%) of double infection with A. lumbricoides and T. trichiura. Overall, 71 (17.4%) of the pregnant women responded to practice geophagia. STHs infection was significantly higher among geophagic pregnant women (p<0.01) and pregnant women who practiced geophagia were 3 times more likely (OR 2.9, 95% CI 1.3-4.2) to have the STHs compared to non-geophagic. Out of those who claimed soil eating habits, 59.1% preferred reddish soil type. Geophagia practice was significantly higher during the third trimester as compared to first and second (p<0.05).. Geophagia is a risky behavior and this study showed a significant association of geophagia practice with STH infections, although the causal relation could not be established.

Topics: Animals; Cross-Sectional Studies; Ethiopia; Female; Helminthiasis; Humans; Pica; Pregnancy; Pregnant Women; Prevalence; Soil

Geophagia is defined as deliberate consumption of earths' materials, e.g. soil, clay and soft stones. The practice is widespread among pregnant women, and there are conflicting views as to whether it is beneficial to health or not. Geophagic materials may be a source of micronutrients though the materials may bind the micronutrients thus reducing or hindering their bioavailability in the body. Geophagia is closely associated with geohelminthic infections among pregnant women and heavy metal poisoning, which constitute significant public health problem in many developing countries such as Kenya. In our research, the geophagic materials consumed by the pregnant women were studied. A total of 38 geophagic materials in the possession by different pregnant women were analysed. The collected samples were subjected to standard digestion procedures and analysed for zinc, lead and iron by atomic absorption spectroscopy. Results indicated that the geophagic materials contained elevated levels of Fe at mean concentration value of 80.10 ppm, Pb at 3.28 ppm and Zn 1.81 ppm for a 1.00 g sample. An average of 20 g of the geophagic materials was being consumed per day. Based on the average consumption, the pregnant women were exposed to 65.52 ppm Pb per day, 36.2 ppm Zn per day and 1602 ppm Fe per day. Lead exceeded the WHO-lead exposure limits of 25 ppm/day for pregnant women. The materials were also subjected to microscopic examination for Ascaris lumbricoides, Trichuris trichiura, Taenia Spp., Necator americanus and Ancylostoma duodenale. In conclusion, the women were exposed to heavy metals-iron, zinc and lead, but there was no observable eggs, larvae or adult species of the geohelminths. The key recommendation was that there is need to integrate public health education on geophagia, lead screening and testing with antenatal support care systems. This will enhance maternal and child health, thus reducing infant and maternal morbidity and mortality rates.

Topics: Adolescent; Adult; Animals; Female; Helminthiasis; Humans; Iron; Kenya; Lead; Metals, Heavy; Pica; Pregnancy; Soil; Soil Pollutants; Spectrophotometry, Atomic; Young Adult; Zinc

Geophagic soils from selected communities in Eastern Cape, South Africa were characterised to determine their properties and geohelminth content. The soils were coarse-textured with cation exchange capacity values ranging from 6.35 to 18.94 cmol (+)/kg. Quartz was the dominant mineral in the samples with SiO2, Al2O3, and Fe2O3(t) having the highest concentrations among major element oxides. The soil properties, mineralogical composition, and low amounts of particle binding substances may favour the survival of geohelminth ova in the soils. Seven of the samples contained at least one of the following geohelminths: Ascaris lumbricoides, Trichuris trichiura, Necator americanus, Ancylostoma duodenale and Strongyloides stercoralis. The presence of these geohelminths in the soils was attributed to agricultural and sanitary practices inherent in the communities and the soil properties. Communities need to be sensitised on the importance of safe sanitary and animal husbandry practices to reduce the prevalence of helminth infection among geophagists.

Topics: Animals; Helminthiasis; Helminths; Humans; Pica; Prevalence; Soil; South Africa; X-Ray Diffraction

Geophagy, the regular and deliberate consumption of soil, is prevalent among pregnant women in sub-Saharan Africa. We examined the associations of geophagy with anemia and helminth infection among 971 human immunodeficiency virus (HIV)-positive pregnant women in Tanzania. About 29% of pregnant women regularly consumed soil. Occupation, marital status, and gestational age were associated with geophagy. Ascaris lumbricoides infection was associated with the prevalence of geophagy (adjusted-prevalence ratio 1.81; 95% confidence interval [CI] = 1.37-2.40); however, hookworm, Trichuris trichiura, and Strongyloides stercoralis showed no association. Anemia and red blood cell characteristics suggestive of iron deficiency were strongly correlated with geophagy at baseline. In longitudinal analyses, we found evidence suggesting that soil consumption may be associated with an increased risk of anemia (adjusted-relative risk 1.16; 95% CI = 0.98-1.36) and a lower hemoglobin concentration (adjusted-mean difference -3.8 g/L; 95% CI [-7.3, -0.4]). Pregnant women should be informed about the potential risks associated with soil consumption.

Topics: Adult; Anemia; Animals; Ascariasis; Ascaris lumbricoides; Female; Helminthiasis; HIV Infections; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Longitudinal Studies; Pica; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Risk Factors; Socioeconomic Factors; Soil; Tanzania; Vitamin A

Fe status is difficult to assess in the presence of infections. To assess the role of the acute- phase response (APR) and other predictors of serum ferritin and transferrin receptor, we conducted a cross-sectional study among pulmonary tuberculosis (PTB) patients in Mwanza, Tanzania. The acute- (serum ferritin) phase protein, serum alpha1-antichymotrypsin (ACT) and serum ferritin and serum soluble transferrin receptor (sTfR) were measured, and data on smoking, soil and alcohol intake, and infection status were collected. Linear regression analysis was used to assess the role of elevated serum ACT and other predictors of serum ferritin and serum sTfR. Of 655 patients, 81.2 % were sputum positive (PTB+) and 47.2 % HIV+. Mean serum ACT was 0.72 g/l, with 91.1 % above 0.4 g/l. Among females and males, respectively, geometric mean serum ferritin was 140.9 and 269.1 microg/l (P < 0.001), and mean serum sTfR 4.3 and 3.8 mg/l (P < 0.001). Serum sTfR was increased 0.5 mg/l and log serum ferritin increased linearly with serum ACT >0.4 g/l. PTB+ and HIV infection, alcohol drinking and smoking were the positive predictors of serum ferritin, and female sex, soil eating, Schistosoma mansoni and hookworm infection were the negative predictors. Similarly, smoking and HIV infection were the negative predictors of serum sTfR, and female sex, soil eating and PTB+ were the positive predictors. Serum ferritin and serum sTfR are affected by the APR, but may still provide information about Fe status. It may be possible to develop algorithms, based on the markers of the APR and Fe status, to assess the Fe status among the patients with tuberculosis or other infections eliciting an APR.

Topics: Acute-Phase Reaction; Adolescent; Adult; alpha 1-Antichymotrypsin; Analysis of Variance; Biomarkers; Chi-Square Distribution; Cross-Sectional Studies; Female; Ferritins; Helminthiasis; HIV Infections; Humans; Iron; Male; Nutritional Status; Pica; Receptors, Transferrin; Schistosomiasis; Tanzania; Transferrin; Tuberculosis, Pulmonary; Young Adult

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.

Topics: Adolescent; Adult; Animals; Ascariasis; Ascaris lumbricoides; Feeding Behavior; Female; Helminthiasis; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Lactation; Longitudinal Studies; Middle Aged; Pica; Pregnancy; Pregnancy Complications, Parasitic; Recurrence; Risk Factors; Soil; Trichuriasis

The most common form of pica, geophagy, has direct adverse nutritional effects and also exposes children to soil-borne infection. Existing methods for assessing geophagy are either inappropriate for field use (radiology) or unreliable (reporting). A new method is described, based on the measurement of soil-derived silica in stools. More than 90% of silica is excreted within one gut transit period of ingestion. The amount excreted is proportional to the amount ingested. Faecal levels of dietary silica (less than 2% dry wt stool) can be distinguished from levels due to geophagy (up to 25% dry wt stool). Studies in 2 children's homes in Jamaica showed that 33% and 66% of children were geophagous, ingesting up to 10 g soil day-1. The geophagy of less than 20% of the children accounted for greater than 60% of the total soil ingested. This overdispersion of exposure to soil-borne infection may contribute to the observed aggregation of geohelminth infection.

Topics: Child; Child, Preschool; Feces; Helminthiasis; Humans; Methods; Pica; Silicon Dioxide; Soil; Time Factors

Topics: Adolescent; Deficiency Diseases; Diarrhea; Dietary Proteins; Female; Helminthiasis; Humans; Hypoproteinemia; Iran; Liver Cirrhosis; Male; Nutrition Disorders; Pica; Protein Deficiency; Protein-Losing Enteropathies; Serum Albumin; Tuberculosis, Gastrointestinal; Zinc

Topics: Adolescent; Adult; Age Factors; Anemia, Hypochromic; Blood Proteins; Body Height; Body Weight; Edema; Female; Growth Disorders; Helminthiasis; Hemoglobinometry; Hepatomegaly; Humans; Infections; Iran; Male; Nutrition Disorders; Pica; Protein Deficiency; School Health Services; Serum Albumin; Serum Globulins; Soil; Splenomegaly; Zinc

Topics: Adolescent; Anemia; Child; Deficiency Diseases; Dyspepsia; Feeding and Eating Disorders; Helminthiasis; Humans; Infant; Infant Nutrition Disorders; Pica