Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya

Abstract

SummaryWe 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 ¼ 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 ¼ 0.07 and P ¼ 0.02 respectively). There were significant differences in the prevalence of A. lumbricoides between geophagous and non-geophagous women at 3 (P ¼ 0.001) and at 6 months postpartum (P ¼ 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 ¼ 0.02), 3 months postpartum (P ¼ 0.001) and at 6 months postpartum (P ¼ 0.001).The intensity of infections with T. trichiura at 6 months postpartum was significantly different between geophagous and non-geophagous women (P ¼ 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.

Geophagy is Associated with Environmental Enteropathy and Stunting in Children in Rural Bangladesh

“…In two studies also conducted in Kenya, geophagy was associated with helminth infections in children. 23,24 This is consistent with the growing body of literature indicating that soil is an exposure route for enteric pathogens. [23][24][25][26] Furthermore, these findings suggest that geophagy may be a potential risk factor for EE and stunting in pediatric populations.…”

“…[23][24][25][26]42 However, despite this growing evidence base, interventions to intervene upon this exposure route for pediatric populations are nonexistent. Furthermore, we found that in our study population that caregivers do little to prevent children from putting soil in their mouth.…”

“…[23][24][25][26] Furthermore, these findings suggest that geophagy may be a potential risk factor for EE and stunting in pediatric populations. However, there are very few published studies assessing geophagy in pediatric populations, [23][24][25][26][27] and none assessing the role of this behavior in EE or stunting.…”

Geophagia is not associated with Trichuris or hookworm transmission in Zanzibar, Tanzania

“…the substance must contain viable nematode eggs or larvae). An association between earth consumption and increased Trichuris and Ascaris burden in earth consumers has been shown in several (Geissler et al, 1998a;Luoba et al, 2005;Saathoff et al, 2002;Wong et al, 1991) but not all (Vermeer and Frate, 1979) studies. Yet, to date, measurement of the parasite content of the soil has been investigated in only two sites (Geissler et al, 1998a;Wong and Bundy, 1990;Wong et al, 1991), no studies have determined the parasite content of earth consumed by adults and no studies have looked at the parasitic content of non-earth pica substances.…”

Geography of ascariasis in Belarus: cultural and anthropological aspectys (Part 2)

“…Наряду с генетическими причинами могут рассматриваться некоторые психофизиологические механизмы, например, такие как геофагия [14]. Поскольку популяции Брестской и Витебской областей отличаются по содержанию характеристик ментальной сферы, то могут выстраиваться гипотетические цепочки между региональными психологическими характеристиками и особенностями эпидемиологического процесса.…”