title: Geophagy during pregnancy in Africa: a literature review.
abstract: BACKGROUND
  Geophagy is a form of pica characterized by craving and eating of soil. The main materials ingested include anthill soils and soft stone. In this review, our objectives were to study the prevalence of geophagy in pregnancy (GiP), establish the risk factors for GiP, assess the effects of GiP on pregnancy outcomes, and recommend possible interventions for reducing GiP.
  
  
  BACKGROUND
  Geophagy among pregnant women is common in many cultures. In some African countries, GiP prevalence of up to 84% has been observed. In Nigeria, the most populous country in Africa, the prevalence of GiP is estimated at 50%. The practice has been associated with religious practice, culture, and famine.
  
  
  METHODS
  It is postulated that GiP is due to micronutrient deficiencies, cultural influences, and gastrointestinal upsets. Despite their potential to supply micronutrients, soils interfere with bioavailability of micronutrients leading to micronutrient deficiency and can also act as a pathway for ingestion of geohelminths and heavy metals, putting woman and fetus at risk. GAPS: Despite its association with anemia, pregnancy, and micronutrients, many antenatal care guidelines or National guidelines on micronutrient deficiency control are silent on GiP. The guidelines generally recommend iron supplementation and deworming of pregnant women as anemia control measures. However, not all women seek antenatal services; hence, there is need for more innovative ways of addressing micronutrient deficiencies in pregnancy.
  
  
  CONCLUSIONS
  It is imperative to enquire whether pregnant women are geophagous and discourage geophagy, strengthen and expand the existing supplementation programs, and mandate flour fortification to enhance population-wide iron supply and safer pregnancies.
  
  
  BACKGROUND
  Obstetricians & Gynecologists and Family Physicians.
  
  
  OBJECTIVE
  After completing this CME activity, physicians should be better able to analyze the prevalence of GiP, identify the risk factors for GiP, and assess the effects of GiP on pregnancy outcomes. In addition to propose remedial interventions for reducing GiP.
authors.affiliation: International Masters in Public Health Program, Hebrew University Braun School of Public Health, Jerusalem, Israel. haron.njiru@hujimail.ac.il
authors.forename: Haron
authors.initials: H
authors.lastname: Njiru
authors.forename: Uriel
authors.initials: U
authors.lastname: Elchalal
authors.forename: Ora
authors.initials: O
authors.lastname: Paltiel
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D000818:Animals; D005260:Female; D006801:Humans; D010842:Pica / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D011295:Prenatal Care