Paradoxically, pica often in the form of geophagia soil eating is also sometimes seen in dogs that are chronically anaemic. Pdf we report a 4yearold male child, who presented with abdominal distension and absolute constipation for 4 days. Njiru 2011 confirmed this finding and indicated that clay soils may obstruct the bioavailability of micronutrients resulting in micronutrient deficiency. Many other descriptive studies also demonstrated a significant decrease in red blood cell number and a decrease in hemoglobin and ferritin concentrations in athletes 20. Geophagy practices and the content of chemical elements in the soil eaten by pregnant women in artisanal and small scale gold mining communities in tanzania. A culturalnutrition health seeking behaviour with no redeeming psychosocial qualities original research. Anaemia in pregnancy is an important public health problem especially in developing countries. Get a printable copy pdf file of the complete article 2. Syndrome of iron deficiency anemia, hepatosplenomegaly, hypogonadism, dwarfism and geophagia. In particular, geophagia is observed during pregnancy as a feature of iron deficiency anemia. When unrecognized and untreated, it can lead to serious complications. Anthropometry, anaemia, geophagia, dietary intake, iron deficiency. Geophagia, also known as geophagy, is the practice of eating earth or soillike substrates such as clay or chalk. A 34yearold woman presented with iron deficiency anaemia refractory to treatment for more than a decade.
Her menstrual blood loss was not unusual, she had never been pregnant, and she. Microbiological health effects associated with geophagia. Pagophagia, or the ingestion of ice, was found to be the most common finding. Shiraz, iran in 1958 a twentyone year old man entered the hospital presenting these clinical features.
Pica, the ingestion of substances that are inappropriate for consumption, is associated with iron deficiency and may be underdiagnosed. It is a complex behavior that can present with any number of variations table 1, and multiple pica determinants range from demands of tradition and acquired tastes in the cultural context to presumptive neurobiological mechanisms eg, iron deficiency, cns. In particular, geophagia is observed during pregnancy 6 or as a feature of irondeficiency anaemia 7. Geophagy, iron status and anaemia among primary school. This is a practice that is common among members of the animal kingdom, including people. Geophagy, iron status and anaemia among pregnant women on. Providing a manual pill press would allow communities to make their own clay.
To conclude, the study found that an association exists between geophagia and haematological parameters of iron deficiency anaemia amongst geophagic. Geophagia is practised by a considerable proportion of pregnant women in johannesburg, especially migrant women. The clinical presentation, endoscopic findings and laboratory investigations were. Geophagia, the eating of soil, particularly clay, is a wellknown folk remedy thought to suppress morning sickness. See what can cause your body to make too few red blood cells. There was no past history of paralysis, weakness, anemia, nausea, vomiting, diarrhea, tetany, or renal disease. This view, however, has largely been based on the bulk nutrient composition of geophagic materials and the. In its diagnostic and statistical manual, the american psychiatric association defines. Geophagia is an ancient practice which is still widely seen in many parts of the world, especially in traditional societies. We investigated if geophagia is restricted to only pregnant and. Geophagia leading to hypokalemic quadriparesis in a.
For example, anemia during pregnancy is defined as hemoglobin hb concentration less than 11 gdl 2 3 4. The prevalence of anaemia observed in the geophagic pregnant population is significantly higher than in the nongeophagic group. However, there is evidence that soil can be a valuable source of trade elements and nutrients. Syndrome of iron deficiency anemia, hepatosplenomegaly, hypogonadism, dwarfism and geophagia ananda s. This study evaluated the potential health risk involved during. The patient stated that for the past two years she had eaten one or more large handfuls of white clay with each meal in addition to her normal diet. The patient ate only bread made from unleavened wheat flour and his intake of animal protein was negligible. Human geophagia may be related to pica, an eating disorder in the diagnostic and statistical manual of mental. In 22 of 23 patients with the symptom of pagophagia and iron deficiency anemia, there was complete disappearance of the symptom when the iron deficiency state was corrected. Of the estimated 1 million yearly deaths in africa and southeast asia, anaemia is reported to account for about 75%. The reticulocyte count is used to assess the appropriateness of the bone marrow response to anemia.
Pagophagia and iron deficiency anemia annals of internal. It occurs in nonhuman animals where it may be a normal or abnormal behaviour, and also in humans, most often in rural or preindustrial societies among children and pregnant women. The similarities between her illness and the clinical picture described over 100 years ago by cragin and carpenter as cachexia africana were striking. Independent and combined effects of improved water. Pdf geophagia is defined as deliberate consumption of earth, soil, or clay1. Soil can influence the human health and caused diseases by different ways. Multiple causes exist, but with a thorough history, a physical examination and limited laboratory evaluation a specific. Testing should be performed in patients with signs and symptoms of anemia, and a complete evaluation should be performed if iron deficiency is. Anemia occurs when your body makes too few rbcs, destroys too many rbcs, or loses too many rbcs. Animals that develop acute severe anaemia may be collapsed andor dyspnoeic on presentation without a history of lethargy or anorexia. The normal reticulocyte count in a patient with a normal hb and hct is about 1%. Geophagy clay may also be a source of microbial infection tanodebrah and brucebaiden, 2010. Anemia among pregnant women is a serious continental issue in africa. Geophagia denotes the habit of eating earth, soil or clay and is not uncommon in southern parts of the united states 5 as well as urban africa.
It is conventionally assumed that geophagia may help supplement mineral nutrients in individuals with limited intake of trace elements such as fe and zn. Anemia and dm anemia is a common complication of dm and correlates with renal failure rate of anemia is higher in patients with diabetic nephropathy than in non diabetic renal disease with similar levels of renal impairment. Any person who studies geophagy undertaken by humans will invariably confront a problem during their research. A crosssectional analytical study of geophagia practices. Others present contrary view of no association between geophagia and anemia 4.
The significantly strong association between geophagia and iron deficiency emphasizes the importance of identifying the practice of geophagia in women, especially during their child bearing years. Globally, anaemia affects about 2 billion people of which over 800 million are children and pregnant women particularly in africa and asia 1, 2. Prevalence of geophagia and its possible implications to health a study in rural. Pica is the pathological craving for and eating of a nonnutritive item eg, clay, coal, paper or food ingredients flour, raw potatoes. Geophagy practices and the content of chemical elements in. Even this early report points to a link between geophagia and anaemia. Many types of anemia exist, such as irondeficiency. Beyond anemia bharat j parmar, jwal doctor, ruhi, ashmita and danu. Geophagia, the deliberate ingestion of soil, is a complex eating behaviour with obscure aetiology and numerous healthmedical problems.
Geophagia seems to always be accompanied by the subject of iron deficiency anaemia and especially its prevalence in females. Anemia healthy changes national heart, lung, and blood. These data illustrated iron deficiency anemia in 2% of male and in 2. Geophagia with iron deficiency anemia and hypokalemia, cachexia africana, arch intern med vol. Anaemia in pregnancy is even more prominent in developing countries with an estimated prevalence ranging from about 56 to 61%.
Geophagic behavior increases exposure to metal contaminants in the soil, including. Geophagia although pleasurable and somewhat a necessity among pregnant women, also comes along with its own attendant problems such as exposure to potentially hazardous substances like bacteria, fungi, helminthes and ova, radioactive materials, and toxic elemental minerals in the soil depending on the geographical location. Prevalence of geophagia and its possible implications to. Physiological effects of geophagy soil eating with.
Geophagy is one of the symptoms of hypochromic microcytic anaemia, associated with hookworm infection and deficient iron intake, especially in. Geophagia, the practice of eating clay, is associated with severe anemia and mechanical bowel disorders. Soils, selected for particular qualities, such as flavour and plasticity, from carefully chosen sites, are consumed for a variety of reasons, from religious to medicinal, as well as part of a regular diet. When something goes wrong in your blood, it can affect your health and quality of life. Geophagia as a risk factor for anaemia need to be further investigated in this community. Haemoglobin levels were determined in all 156 children and serum ferritin concentrations in 5. Syndrome of iron deficiency anemia, hepatosplenomegaly. Geophagia in children has a strong association with anemia and has good response to oral. Anemia in children is commonly encountered by the family physician. Iron and mineral deficiency associated with the practice of geophagia m van wyk, jm kuyl, ce brand, lf.
Many diseases, conditions, and other factors can cause this to happen. Microcytic hypochromic anemia m qari differential diagnosis of microcytic hypochromic anemia iron deficiency and iron deficiency anemia the anemia of chronic disorders sideroblastic anemias thalassemia major lead poisoning hereditary pyropoikilocytosis iron metabolism most body iron is present in haemoglobin in circulating red. Geophagy and the involuntary ingestion of soil springerlink. Anaemia, the p use of african traditional medicines and craving of nonnutritive substances in a previous pregnancy were associated with geophagia. Iron deficiency is the most common cause of anaemia worldwide. The investigation of iron and mineral deficiency associated with the practice of geophagia by mari van wyk n dip biomedical technology. Helminthes infection that leads to anemia due to blood loss from the intestine can result from geophagy. Physicians should enquire about pica while taking dietary history in case of unexplained metabolic abnormality hypokalemia and nutrient deficiencies. Links to pubmed are also available for selected references. It is a major cause of maternal morbidity and mortality, and also has a significant impact on the. The relationship of hookworm infection, anaemia and iron status in a papua new guinea highland population and the response to treatment with iron and mebendazole.
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