Abstract:
Geophagy, the regular and deliberate consumption of non-food substances like soil is
said to be common among pregnant women in Sub-Saharan Africa. This study aimed to
investigate geophagy among pregnant women who attended the antenatal care clinic at
Thika Level-5 Hospital, in relation to parasitic infections. Study objectives were to
determine the prevalence of geophagy and intestinal parasitic infections among the study
women, and association between geophagy and intestinal parasitic infections. A total of
four hundred and ten (410) study participants were enrolled in this cross-sectional,
hospital-based study. A questionnaire was administered to collect personal and
behavioural information; faecal samples were collected for microscopic diagnosis of
intestinal parasitic infections on direct faecal smears and Kato-Katz smears, and finger
prick blood taken for haemoglobin determination. Out of the 410 participants enrolled,
26.1% (n=107) practiced geophagy, majority of whom practiced it only occasionally. It
was observed that 92.5% of the study participants preferred soil purchased from market
places and 11% of the study women examined were infected with intestinal parasitic
infections. The parasites detected in faecal samples were Entamoeba histolytica (8.8%),
Trichuris trichiura (1%), Ascaris lumbricoides (1%), Schistosoma mansoni (0.7%), and
Strongyloides stercoralis (0.2%). None of the 5 intestinal parasites detected were,
however associated with geophagy, P>0.05. Interestingly, only E. histolytica (8.4%) was
found in women who practised geophagy. Furthermore, gestation period was associated
with E. histolytica infection, p=0.049, with those who ate soil from the garden being
more likely to have an E. histolytica infection, (p=0.026). Also closely associated with
geophagy were level of education (p=0.009), feeding problems (p=0.000) and history of
practising geophagy (p=0.000). Majority of the women (64.9%, n=266) had normal
levels of haemoglobin (11gm/dl and above), (32.7%, n=134) were mild anaemic (Hb
levels 10.0-10.9gm/dl), 1.5% (n=6) were moderately anaemic (Hb levels 7-9.9gm/dl),
and 1% (n=4) were severely anaemic (<7gm/dl). Those who practised geophagy (34.6%)
had mild anaemia, while <5% had moderate or severe anaemia based on the WHO
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classification for anaemia in pregnant women. While geophagy was not significantly
associated with parasitic infections in the pregnant women attending Thika Hospital,
geophagy was found to be significantly associated with education and feeding problems.
Besides, pregnancy trimester and the source of soil were found to be associated with E.
histolytica infection. This study recommends a need for extensive and intensive public
health education to advocate for the necessity of hygiene and sanitation and also impact
knowledge on the risks and benefits of geophagy, provision for a mineral
supplementation program, formulation of a policy on the routinely deworming of
pregnant women in their 2nd trimester, have a routine testing of amoebiasis in pregnant
women and treatment of the infected especially in the 2nd trimester and need for the
Bureau of Standards to ensure that soil sold in markets, supermarkets or by the vendors
is 100% safe from parasites and heavy metals, also set rules and regulations on
sterilization and packaging. Further studies are recommended to determine the role
played by soil from different sources in the transmission of parasitic infections in
pregnant women practicing geophagy and to compare the immune systems of pregnant
women in the different gestation trimesters.