Mathee Angela, Naicker Nisha, Kootbodien Tahira, Mahuma Tshepo, Nkomo Palesa, Naik Inakshi, de Wet Thea
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.
S Afr Med J. 2014 Jun 19;104(8):568-73. doi: 10.7196/samj.7466.
Geophagia, a form of pica, has been shown to be widely practised in sub-Saharan Africa, especially among pregnant women.
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.
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.
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.
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.
食土癖是异食癖的一种形式，在撒哈拉以南非洲地区广泛存在，尤其是在孕妇中。
评估2010年6月至7月期间在南非约翰内斯堡拉希玛·穆萨母婴医院产前门诊就诊的妇女中食土癖的患病率，并检测其对特定金属的暴露情况及相关危险因素。
我们对307名年龄在18至46岁之间的孕妇进行了一项横断面研究，选取的是方便样本。通过结构化访谈了解食土癖行为。采集血样以测定血红蛋白值以及砷、镉、汞和铅的浓度。根据情况进行χ²检验、威尔科克森秩和检验以及逻辑回归分析等统计分析。
平均产次为1.4，平均（标准差）孕周为30.3（6.0）周。60名妇女（19.5%）报告有食土癖，其中大多数从街头小贩处购买泥土（83.3%）。研究样本中贫血患病率为16.9%（95%置信区间13.1 - 21.6%）。有食土癖的妇女血铅水平显著高于无食土癖的妇女（2.1对1.4μg/dl；p<0.001）。贫血、使用非洲传统药物以及前次妊娠时有对非营养物质的渴望与食土癖有关。
约翰内斯堡相当一部分孕妇有食土癖行为，尤其是流动妇女。作为产前保健计划的一部分，可能需要对异食癖，尤其是食土癖提高警惕，以避免这种行为对健康造成潜在的有害影响。
