title: 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.
abstract: BACKGROUND
  Geophagy, a form of pica, is the deliberate consumption of soil and is relatively common across Sub-Saharan Africa. In Tanzania, pregnant women commonly eat soil sticks sold in the market (pemba), soil from walls of houses, termite mounds, and ground soil (kichuguu). The present study examined geophagy practices of pregnant women in a gold mining area of Geita District in northwestern Tanzania, and also examined the potential for exposure to chemical elements by testing soil samples.
  
  
  METHODS
  We conducted a cross sectional study using a convenience sample of 340 pregnant women, ranging in age from 15-49 years, who attended six government antenatal clinics in the Geita District, Tanzania. Structured interviews were conducted in June-August, 2012, to understand geophagy practices. In addition, soil samples taken from sources identified by pregnant women practicing geophagy were analysed for mineral element content.
  
  
  RESULTS
  Geophagy was reported by 155 (45.6%) pregnant women with 85 (54.8%) initiating the practice in the first trimester. A total of 101 (65%) pregnant women reported eating soil 2 to 3 times per day while 20 (13%) ate soil more than 3 times per day. Of 155 pregnant women 107 (69%) bought pemba from local shops, while 48 (31%) consumed ground soil kichuguu. The estimated mean quantity of soil consumed from pemba was 62.5 grams/day. Arsenic, chromium, copper, iron, manganese, nickel and zinc levels were found in both pemba and kichuguu samples. Cadmium and mercury were found only in the kichuguu samples. Based on daily intake estimates, arsenic, copper and manganese for kichuguu and copper and manganese for pemba samples exceed the oral Minimum Risk Levels designated by the U.S. Agency for Toxic Substance and Disease Registry.
  
  
  CONCLUSIONS
  Almost 50% of participants practiced geophagy in Geita District consistent with other reports from Africa. Both pemba and kichuguu contained chemical elements at varying concentration, mostly above MRLs. As such, pregnant women who eat soil in Geita District are exposed to potentially high levels of chemical elements, depending upon frequency of consumption, daily amount consumed and the source location of soil eaten.
authors.affiliation: School of Public Health, Catholic University of Health and Allied Sciences, P,O, Box 1464, Bugando Area, Mwanza, Tanzania. elcnyanza@gmail.com.
authors.forename: Elias C
authors.initials: EC
authors.lastname: Nyanza
authors.forename: Mary
authors.initials: M
authors.lastname: Joseph
authors.forename: Shahirose S
authors.initials: SS
authors.lastname: Premji
authors.forename: Deborah Sk
authors.initials: DS
authors.lastname: Thomas
authors.forename: Cynthia
authors.initials: C
authors.lastname: Mannion
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006046:Gold; D006801:Humans; D015994:Incidence; D007287:Inorganic Chemicals / Q000032:analysis*; D018811:Maternal Exposure / Q000009:adverse effects*; D008875:Middle Aged; D008906:Mining; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012189:Retrospective Studies; D012987:Soil / Q000737:chemistry*; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
chemical_list: D007287:Inorganic Chemicals; D012987:Soil; D006046:Gold
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