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


Luoba, A; Geissler, PW; Ouma, JH; Estambale, B; Magnussen, PM; Friis, H; (2005) Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya. Tropical medicine & international health, 10 (3). pp. 220-227. ISSN 1360-2276 DOI: https://doi.org/10.1111/j.1365-3156.2004.01380.x

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Abstract

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

Item Type: Article
Keywords: Adolescent, Adult, Animals, Ascariasis, etiology, Ascaris lumbricoides, Feeding Behavior, Female, Helminthiasis, etiology, Hookworm Infections, etiology, Humans, Intestinal Diseases, Parasitic, etiology, Lactation, Longitudinal Studies, Middle Aged, Pica, complications, Pregnancy, Pregnancy Complications, Parasitic, etiology, Recurrence, Research Support, Non-U.S. Gov't, Risk Factors, Soil, parasitology, Trichuriasis, etiology
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 15730505
Web of Science ID: 227188500004
URI: http://researchonline.lshtm.ac.uk/id/eprint/13134

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