South Asian Journal of Parasitology

Geophagy as a Risk Factor for Geohelminth Infections among Women in Enugwu Agidi Community: Anambra State, Nigeria

Ogbodo, F.C. *

Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria.

Ngenegbo, U.C.

Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria.

Umeanaeto, P.U.

Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria.

Ikpeze, O.O.

Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria.

Onyido, A.E.

Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria.

Iwueze M. O

Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria.

Obijiofor, E.C.

Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria.

*Author to whom correspondence should be addressed.

---

Abstract

Aim: The aim of this study was to determine the prevalence of soil- transmitted helminthes and geophagy as a behavioural risk factor among women in Enugwu-Agidi, Njikoka Local Government Area, Anambra State, Nigeria.

Study Design:  A community based cross sectional study, discriptive study.

Place and Duration of Study:  Women in Enugwu-agidi community, Anambra state, between May to December, 2023.

Methodology: A total of 264 women aged below 20 and above 51 years old were enrolled for the study and a total of 264 faecal samples collected and analyzed using direct faecal smear and formol-ether sedimentation techniques for estimation of prevalence. Both quantitative and qualitative surveys involving in-depth interviews and pretested questionnaires were used in determining the predisposing risk factors, the level of knowledge and impact of geophagy among both pregnant and non-pregnant women. The relationship between each variable and geohelminths prevalence was analyzed using Chi square. Test of statistical significance was set at P-value of 0.05 (95%) confidence interval.

 Results: Of the 264 faecal samples examined, 108 (40.9%) were positive with one or two STHs eggs/larvae. The eggs/larvae recovered from stool samples examined were Ascaris lumbricoides 58(53.7%), Hookworm 26(24.1%) and Trichuris trichiura 24(22.2%).  The study showed that 61.3% of women interviewed practiced geophagy at the time of the study. Prevalence of STHs parasites was higher (61.3%) among those who practiced geophagy than those who do not (17.2%). Similarly, pregnant women who practiced geophagy were more infected with STHs parasites (63.8%) than those who were not pregnant (56.3%). The preference for the soil type was ranked as clay, termite mounds from tree trunk and hut bricks. Perceived reasons for geophagy included dimished cravings when they eat clay, prevention of vomiting and nausea and others ingested soil for taste. Possible health risks involved in geophagy such as abdominal discomfort, heartburn.

Conclusion:  Consumption of geophagic clay has significant association with contraction of STHs infections. Sensitization and mass education of women on the dangers of geophagy is needed. Guidelines should be developed for implementation of routine faecal examination screening procedure for all women especially pregnant women attending antenatal clinics so that mass management can be offered to all pregnant women.

Keywords: Geophagy, soil-types, geohelminth infections, Trichuris trichiura, Ascaris lumbricoides, Hookworm, women, enugwu agidi the abstract should be in brief, with reduce the keyword

---

---

---

References

Ohuche I, Ayuk A, Ubesie A, Onu J, Ibe B. Soil-transmitted helminthiases: A neglected tropical diseases among urban dwelling school aged children in a sub Saharan African city. Nigerian Postgraduate Medical Journal. 2020; 27:184-189.

Adriko M, Tinkitina B, Arinaitwe M, Kabaterinene N, Nanyunja M, Tukahebwa E. Impact of a national deworming campaign on the prevalence of soil-transmitted helminthiasis in Uganda. Implications for national control programs. PLoS One Neglected Tropical Diseases. 2018;4(3):4-14.

World Health Organization (WHO). Soil-transmitted helminth infections; 2022. Available:https://www.who.int/topics/soil-transmitted-helminthiases/en/

Ohiolei JA, Isaac C, Omorodion OA. A review of soil transmitted helminthiasis in Nigeria. Asian Pacific Journal of Tropical Disease. 2017; 7(12): 841-848.

Federal ministry of health. Nigeria master plan for neglected tropical diseases (NTDs) 2013–2017, Abuja: Federal Ministry of Health. 2013;142 p13.

Oluwole AS, Ekpo UF, Karagiannis-Voules DA, Abe EM, Olamiju FO, Isiyaku S. Bayesian geostatistical model-based estimates of STHs infections in Nigeria, including annual deworming requirements. PLoS Neglected Tropical Diseases. 2015; 9(4):7-15.

Adewale B, Mogaji H, Balogun J, Balogun E, Olanuju F, Herbert D. Mornitoring the status of soil transmitted helminthes in non- endemic implementation units: A case study of Borgu in North Central Nigeria. Pathogens. 2023;12(3):149. DOI: 10.3390/pathogens.

Van Eijk AM, Lindblade B, Odhiambo F. Geohelminth infections among pregnant women in rural western Kenya: a cross-sectional study. PLoS Neglected Tropical Diseases. 2009;3(1):e370

Ngenegbo UC, Alozor OA, Ikpeze OO, Chikwendu JI. Intestinal helminth infections in pupils of a rural community in Nigeria. The Bioscientist Journal. 2022;10 (3):326-336.

Schlosser-Bradenburg J. Intestinal infections with soil-transmitted helminthic infections and their impact on coinfections. Reviews on Immunology and Immune Evasion, 2022; 2023.

Hurlimann E, Yapi RB, Houngbedji CA, Schmidin T, Kuadio BA, Silue KD, Quattara M, N’Goran EK, Utzinger J, Raso G. The Epidemiology of Poly-parasitism and Implications for Morbidity in Two Rural Communities of Cote d’Ivoire.Parasite Vectors. 2014;7:81.

Anunobi AJ, Okoye I, Aguzie I, Ndukwe Y, Okpasuo O. Risk of soil-transmitted helminthes among agrarian communities of Kogi state, Nigeria. Annals of Global Health. 2019;85(1):120.

Karshima SN. Prevalence and distribution of soil-transmitted helminth infections in Nigerian children: a systematic review and meta-analysis. Infectious Diseases of Poverty. 2018;7:69.

Tefera E, Belay T, Mekonnen SK, Zeynudin A, Belachew T. Prevalence and intensity of soil transmitted helminths among school children of Mendera Elementary School, Jimma, Southwest Ethiopia.The Pan African Medical Journal. 2017;27:88.

Kumie A, Ali A. An overview of environmental health status in Ethiopia with particular emphasis to its organization, drinking water and sanitation; A literature survey. Ethiopia Journal of Health Development. 2005;19(2):89 -103.

Hotez PJ, Kamath A. Neglected tropical diseases in Sub-Saharan Africa: review of their prevalence, distribution and disease burden. PLoS Neglected Tropical Diseases. 2009;3(8):1-10.

Alli JA, Okonko IO, Kolade AF, Nwanze JC, Dada VK,Ogundele M. Prevalence of intestinal nematode infection among pregnant women attending antenatal clinic at the University College Hospital, Ibadan, Nigeria. Advances in Applied Science Research. 2011;2 (4):1-13.

Okafor FC, Eneanya CI, Onyenwe NE. Geophagy among pregnant women in Enugu, Nigeria: Cultural and obstetric perspectives. Journal of Public Health in Africa. 2014;5(1),184-188. DOI: 10.4081/jphia.2014.224

World Health Organization (2019). Soil-transmitted helminth infections. Available:https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth- infections

Accessed on: 10th August, 2019.

Young SL, Wilson MJ, Miller D. A review of geophagy and its implications for maternal health. Maternal and Child Nutrition. 2020; 16(4):e12935. DOI: 10.1111/mcn.12935

Adewale B, Rahaman O, Aina O, Sulyman MA. Schistosoma mansoni and soil -transmitted helminth (STH) infections among pregnant women attending primary health care facilities in Lagos Mainland, Nigeria. Journal of Biosciences and Medicines. 2018; 6: 64-70.

Cheesebrough M. District laboratory practice in tropical countries. Part 2, Cambridge University Press, 2004; 2009.

Cheesebrough M. District laboratory practice in tropical countries. Part 2, Cambridge University Press; 2004.

Ratemo GG, Mysioki SK, Nyachongi BO. Association between consumption of geophagic substance and helminthic infections among pregnant women in Kissy County, Kenya. West African Journal of Medicine. 2022;39(6):557-62

Getachew M, Yeshigeta R, Tiruneh A, Alemu Y, Derele E, Mekonnen Z. Soil-transmitted helminthic infections and geophagia among pregnant women in Jimmai Town Health Institutions, Southwest, Ethiopia. Ethiopian Journal of Health Science. 2021;31(5):1033-1042. DOI: 10.4314/ejhs.v31i5.16

Ozumba UC, Ozumba NA, Anya S. Helminthiasis in pregnancy in Enugu, Nigeria. Journal of Health Sciences. 2005; 51:291-3.

Liabsuetrakul T, Chaikongkeit P, Korviwattanagarn S, Petrueng C, Chaiya S, Hanvattanakul C. Epidemiology and effect of treatment of soil transmitted helminthiasis in pregnant women in southern Thailand, Southeast Asian. Journal of Tropical Medicine and Public Health.2009;40:211-22

Dimejesi IB, Umeora OU, Egwuatu VE. Prevalence and pattern of soil-transmitted helminthiasis among pregnant women in a tertiary health facility, southeast Nigeria.African Journal of Medical Health Science. 2014; 13:56-61.

Ngozi PO. Pica practices of pregnant women in Nairobi, Kenya. East African Medical Journal. 2008;85(2):72 -79.

Njiru H, Elchalal U, Paltiel O. Geophagy during pregnancy in Africa: A literature review. Obstetrics and Gynaecology Survey. 2011;66(7):452-459.

Young SL. Pica in Pregnancy: New ideas about old condition. Annual Review of Nutrition.2010;30:403-422.

Salawu OT, Odaibo AB. Maternal schistosomiasis: A growing concern in sub-Saharan Africa. Pathogens and Global Health. 2014;108:263-270.

Nzeukwu C, Ihejie P, Irikannu K, Umeanaeto P, Nzeukwu A, Elosiuba N, Onwuachusi G, Obiefule, Aniefuna C. Prevalence and risk factors for soil-transmitted helminthe; 2022.

Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Aboyans V. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):21-63.

Janz TG, Johnson RL, Rubenstein SD. Anaemia in the emergency department: evaluation and treatment. Emergency Medicine Practice. 2013;15 (11):1–15.

Smith JL, Brooker S. Impact of hookworm infection and deworming on anaemia in non-pregnant populations: a systematic review. Tropical Medicine International Health. 2010;15:776–795

Omorodion OA, Isaac C, Nmorsi OPG, Ogoya EM, Agholor KN. Prevalence of intestinal parasitic infection among tertiary institution students and pregnant women in south-south, Nigeria. Journal of Microbiology and Biotechnology Research. 2012;2(5):815-819.

Smith Jr RE. The clinical and economic burden of anemia. Am J Manag Care. 2010;16(Suppl Issues):S59-66.

Salam N, Azam S. Prevalence and distribution of soil-transmitted helminth infections in India. BMC Public Health. 2017;17:1-2.

Widjana DP, Sutisna P. Prevalence of soil-transmitted helminth infections in the rural population of Bali, Indonesia. Southeast Asian Journal of Tropical Medicine and Public Health. 2000;31(3):454-9.