pica and Intestinal-Diseases--Parasitic

Geophagy is widespread among women from Sub-Saharan Africa, South America and the Caribbean and may persist in western countries. This practice may be associated with adverse effects such as anaemia, constipation or intestinal occlusion. We aimed to determine the prevalence of geophagy and the level of knowledge about its health effects among healthy adults originating from these countries and attending a travel medicine and international vaccination consultation in France. Among 101 travellers enrolled in the study, 83 (82.1%) were born in Sub-Saharan Africa and 13 (12.8%) in South America or the Caribbean. The mean duration of residence in France was 15.6 ± 10.4 years. Previous or current geophagy was present in 42 travellers [previous geophagy in 31 (30.7%) and current consumption in 11 (10.9%)]; 38 (90.5%) were women. The rate of awareness of harmful effects of geophagy as the risk of iron-deficient anaemia (18.8%) and soil-transmitted intestinal parasitic infections (11.9%) was low overall. Women with previous or current geophagy more often had history of iron therapy compared to those who never consumed, both during pregnancy (50.0 versus 14.3%; p = 0.0009) and outside pregnancy (47.4 versus 2.8%; p < 0.0001). Despite a long period of residence in France, geophagy was still a current practice among 10.9% of Sub-Saharan, South American and Caribbean travellers, who are poorly informed of its harmful effects. Therefore, specific information tailored to Sub-Saharan, South American and Caribbean about the risks of geophagy should be implemented in western countries.Level of evidence Level V, descriptive cross-sectional survey.

Topics: Adult; Africa South of the Sahara; Anemia, Iron-Deficiency; Caribbean Region; Constipation; Emigrants and Immigrants; Female; France; Health Knowledge, Attitudes, Practice; Heavy Metal Poisoning; Humans; Intestinal Diseases, Parasitic; Intestinal Obstruction; Male; Middle Aged; Pica; Prevalence; Soil; South America

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

Intestinal parasitism is common among children in developing countries, but the risk factors for infection are not well characterized.. A stool examination was performed on 286 randomly selected children aged 1-18 years from three rural villages in Guinea, Africa. Information collected by questionnaire was used to examine the relationship between geophagia and infection with intestinal nematodes acquired by ingestion versus skin penetration.. Fifty-three per cent of children were infected by at least one type of soil-transmitted nematode. Geophagia was reported by parents to occur in 57%, 53%, and 43%, of children ages 1-5, 6-10, and 11-18 years, respectively. The pattern of geophagia by age and gender of the children more closely resembled the infection pattern for the two orally acquired and soil-transmitted nematodes (Ascaris lumbricoides, Trichuris trichiura) than it did the infection pattern for the two soil-transmitted nematodes that infect by skin penetration (hookworm, Strongyloides stercoralis).. These findings demonstrate that geophagia is an important risk factor for orally acquired nematode infections in African children. Education regarding geophagia prevention should be an integral component of any soil-transmitted parasite control programme.. Intestinal parasites are routinely found among children in developing countries, but the risk factors of such infection are poorly characterized. The stools of 286 randomly selected children aged 1-18 years from 3 rural villages in Guinea were examined. Data collected via questionnaire were then analyzed to assess the relationship between geophagia, the regular ingestion of soil, and infection with intestinal nematodes acquired through ingestion rather than through skin penetration. 53% of children were infected with at least 1 type of soil-transmitted nematode, and geophagia was reported by parents to occur in 57%, 53%, and 43% of children aged 1-5, 6-10, and 11-18 years, respectively. The pattern of geophagia by age and gender of the children more closely resembled the infection pattern for the 2 orally acquired and soil-transmitted nematodes Ascaris lumbricoides and Trichuris trichiura than it did the infection pattern for the 2 soil-transmitted nematodes which infect by penetrating the skin, hookworm and Strongyloides stercoralis. Geophagia is therefore an important risk factor for orally acquired nematode infections among African children, and education on geophagia prevention should be an integral component of all soil-transmitted parasite control programs.

Topics: Adolescent; Child; Child, Preschool; Female; Guinea; Humans; Infant; Intestinal Diseases, Parasitic; Logistic Models; Male; Nematode Infections; Pica; Prevalence; Rural Population; Soil

Parasite levels were determined for 141 members of a naturally formed social group of rhesus macaques living under free-ranging conditions. Results indicate that group members harbor Trichuris trichiura, Balantidium coli, and large numbers of Strongyloides fuelleborni. Parasite counts decrease significantly with age in this population. Females have significantly fewer parasites than males and a significantly lower prevalence of multiple infections. There were no rank effects regarding parasitosis. While 89% of the animals examined are infected with one or more species of enteric parasite, the prevalence of diarrhea is negligible (2%). The low prevalence of diarrhea in the presence of high parasite loads may be due to the practice of geophagy, which is engaged in by 76% of group members. Soil eaten by these monkeys contains large amounts of kaolinitic clays. Kaolin-based pharmaceuticals (i.e. Kaopectate) are commonly used in human populations to treat diarrhea and intestinal upsets. The mechanical and pharmaceutical properties of the natural kaolinite-based clays may counteract the effects of parasitosis in this free-ranging population.

Topics: Animals; Balantidiasis; Balantidium; Diarrhea; Feeding Behavior; Female; Intestinal Diseases, Parasitic; Kaolin; Macaca mulatta; Male; Monkey Diseases; Pica; Prevalence; Soil; Strongyloides; Strongyloidiasis; Trichuriasis; Trichuris

Topics: Adult; Behavior Therapy; Female; Human Coprophagia; Humans; Hygiene; Intellectual Disability; Intestinal Diseases, Parasitic; Male; Oral Hygiene; Pica