Geophagy as a risk factor for Soil-transmitted helminthic infections among pregnant women attending antenatal care at health institutions in Chiro Town, Eastern Ethiopia

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BACKGROUND: Geophagia is recognized as a habit of compulsive eating of soil and is practiced globally, especially among African societies. It is especially common among pregnant women. This behavior may increase the risk of soil-transmitted helminth (STH) infections, which can adversely affect maternal health. This study aimed to assess the association between geophagy and STH infections, as well as to identify related risk factors among pregnant women attending antenatal care at health institutions in Chiro Town, Eastern Ethiopia. METHODS: A multicenter, cross-sectional study was conducted from July 1 to September 30, 2022, among 404 pregnant women attending antenatal care at three public health facilities in Chiro Town, using a convenience sampling. Data on socio-demographics and geophagy-related factors were collected through a semi-structured questionnaire. Single stool samples were examined for STHs using direct saline wet mount and Kato-Katz methods. Soil samples were collected from geophagous women's identified sources and analyzed by a concentration technique. Data were analyzed with SPSS v26 using descriptive statistics and logistic regression, with p < 0.05 at 95% CI considered significant. RESULTS: Among the pregnant women studied, 21.5% were infected with STHs, while 16.8% reported practicing geophagy. A. lumbricoides (13.4%) and hookworms (4.7%) were the most commonly identified helminths. A total of 45 soil samples were collected from various sources identified by geophagic women; of these, five tested positive for Ascaris eggs and two for hookworm-like larvae. Multivariable analysis showed that geophagy [AOR = 2.9 (95% CI = 1.6-5.4)], lack of hand washing before meals [AOR = 2.5 (95% CI = 1.4-4.6)], and consumption of raw vegetables [AOR = 3.2 (95% CI = 1.5-6.5)] were significantly associated with STH infections. In addition, illiterate women were twice as likely to practice geophagy [AOR = 2.0 (95% CI = 1.1-3.8)]. CONCLUSION: This study highlights the high prevalence of STH infections among pregnant women and identifies geophagy as a potential risk factor, though reliance on a single stool sample and a less sensitive diagnostic method may have underestimated the true prevalence. To reduce the risk of these infections, it is crucial to promote awareness of the importance of regular handwashing, avoiding the consumption of raw vegetables, and refraining from the practice of geophagy.

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