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A cross-sectional analytical study of geophagia practices and blood metal concentrations in pregnant women in Johannesburg, South Africa

Angela Mathee, Nisha Naicker, Tahira Kootbodien, Tshepo Mahuma, Palesa Nkomo, Inakshi Naik, Thea De Wet

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.


Authors' affiliations

Angela Mathee, Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg; Faculty of Health Sciences, University of Johannesburg, South Africa

Nisha Naicker, Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Tahira Kootbodien, Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa

Tshepo Mahuma, Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa

Palesa Nkomo, Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa

Inakshi Naik, Analytical Services Department, National Institute for Occupational Health, Johannesburg, South Africa

Thea De Wet, Department of Anthropology and Development Studies, Faculty of Humanities, University of Johannesburg, South Africa; Centre for Anthropological Research, University of Johannesburg, South Africa

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Keywords

Pica; Geophagia; Pregnancy; Lead exposure; Migrants; South Africa

Cite this article

South African Medical Journal 2014;104(8):568-573. DOI:10.7196/SAMJ.7466

Article History

Date submitted: 2013-09-02
Date published: 2014-06-19

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