Geophagy during pregnancy in Africa: a literature review.
ABSTRACT 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.
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.
Obstetricians & Gynecologists and Family Physicians.
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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ABSTRACT: Background. Geophagia, a form of pica, has been shown to be widely practised in sub-Saharan Africa, especially among pregnant women.Objective. To assess the prevalence of geophagia and examine exposure to selected metals and associated risk factors in women attending an antenatal clinic at Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa, during June and July 2010.Methods. We conducted a cross-sectional study on a convenience sample of 307 pregnant women, ranging in age from 18 to 46 years. Structured interviews were conducted to understand geophagia practices. Blood samples were collected to determine haemoglobin values and concentrations of arsenic, cadmium, mercury and lead. Statistical analyses using the χ2 test, Wilcoxon's rank-sum test and logistic regression analyses were performed as appropriate.Results. Mean parity was 1.4 and the mean (standard deviation) gestational age 30.3 (6.0) weeks. Geophagia was reported by 60 women (19.5%), and the majority purchased soil from street vendors (83.3%). The prevalence of anaemia in the study sample was 16.9% (95% confidence interval 13.1 - 21.6%). Geophagic women had significantly higher blood lead levels than non-geophagic women (2.1 v. 1.4 µg/dl; p<0.001). Anaemia, the use of African traditional medicines and craving of non-nutritive substances in a previous pregnancy were associated with geophagia.Conclusions. Geophagia is practised by a considerable proportion of pregnant women in Johannesburg, especially migrant women. Greater vigilance in respect of pica, especially geophagia, may be needed as part of antenatal care programmes to avoid potentially detrimental health effects of the practice.08/2014; 104(8):568-73. DOI:10.7196/samj.7466
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ABSTRACT: •Workshop of cancer research needs in people living by South Africa gold mine tailings.•Environmental measures indicate uranium contamination around gold mine tailings.•Epidemiologic research of human exposures to gold mine tailings currently lacking.•Well-designed epidemiologic studies with individual exposure and outcome data needed.Cancer Epidemiology 10/2014; DOI:10.1016/j.canep.2014.06.003 · 2.56 Impact Factor
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ABSTRACT: Most pregnant women in Burkina Faso are iron deficient and many are anemic. This study assessed women's understanding of anemia and the role of iron in preventing and treating this condition. A qualitative study was conducted within a randomized controlled trial of weekly iron supplementation in a rural malaria endemic area. Focus groups with women of similar age, parity, and marital status took place in 12 of 24 study villages. Two additional focus groups were conducted with female field workers. Tape-recorded transcripts were translated into French and analyzed using Framework analysis. Anemia, for which no Mooré term or traditional treatment for anemia was evident, was described in terms of blood volume. Moderate blood loss (diminished blood) could be easily replaced by eating well and was not considered serious. Massive blood loss (finished blood) was a rare, life-threatening illness. Iron tablets could increase blood volume and help women withstand massive blood loss at delivery, but for the latter, transfusion was indicated. Women had no knowledge of iron's role and did not readily concede that iron supplements contained elemental iron. Neither adolescents nor field workers were convinced of the benefits of supplementing non-pregnant adolescents, who were incorrectly considered to be at low risk of anemia. Young women's knowledge of anemia did not provide an adequate explanatory framework to motivate anemia prevention. Improving information on the role of iron is especially important for adolescent girls who may be incorrectly considered at low risk of anemia as they have not yet experienced pregnancy.Maternal and Child Health Journal 08/2014; 18(8). DOI:10.1007/s10995-014-1443-x · 2.24 Impact Factor