Thesis (M. Tech. (Biomedical Technology)) -- Central University of Technology, Free State, [2014] / Pica is the habitual eating of non-food substances by humans and animals. It has
different subgroups and these are defined by the ingested substance. Moreover,
geophagia is a type of pica that refers to the consistent eating of mostly earth and
earth-like substances such as clay and soil. It is observed in both sexes, all age
groups and in different ethnic groups around the world. There are many reasons
people give for the practice of geophagia, such as culture, hunger and health being
the most prominent. Geophagic materials differ in texture, colour and taste. Soil
colour classification according to the Munsell soil classification, which uses hues,
values and chroma, sometimes differ with the soil colour being noticeable with the
naked eye. However, geophagic clays from Qwa-Qwa are white and contain kaoline.
Geophagic materials are believed to augment mineral deficiency, especially
magnesium, calcium and iron. Geophagia is practised mainly by females, especially
during their child bearing years. Females are more prone to iron deficiency anaemia
due to their monthly menstruation cycle. Iron deficiency is the most common cause
of anaemia and is classified as hypochromic microcytic anaemia (HMA). This study
focused on the health aspect of geophagia. The research question seeks to explore
whether there is an association between geophagia and the haematological
parameters of iron deficiency anaemia. Geophagia seems to be linked with the
occurrence of anaemia, but not iron deficiency anaemia, although it is implied. It is
not known if the practice of geophagia causes iron deficiency anaemia or if it is
because of iron deficiency anaemia that people practise geophagia. A pilot study
was done in 2007, and the results of that study prompted that this study be
performed on a bigger scale.
The lack of information regarding the quantity, frequency and type of geophagic
material consumed the impact of geophagia on haematological parameters and the
iron status of the geophagists made it important that the primary existence of the
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relationship be investigated. In addition, research to establish whether there is a
relationship between geophagia and haematological parameters of iron deficiency
anaemia, has not been undertaken in South Africa, especially on non-pregnant
women. Geophagia seems to always be accompanied by the subject of iron
deficiency anaemia and especially its prevalence in females. The bigger geophagia
project was therefore an ideal opportunity to do a specific survey on geophagic
women.
This was a cross-sectional study, consisting of 36 control women and 47 geophagic
women, aged between 18-45 years. The participants completed a questionnaire to
determine the geophagic practices, which included the colour of the clay, how
frequent the clay was consumed, how much was consumed and for how long it has
been consumed. Nutritional status was assessed using a food frequency
questionnaire. Blood was drawn to assess the haematological and iron status of the
participants.
The participants of the study were within the required age range, with no significant
difference between the groups (p-value=0.7914). The most consumed colour of clay
was white and white clay contains kaoline, which has the ability to absorb iron in the
duodenum. The majority of the participants consumed 40 grams of clay on a daily
basis, with most of the participants having done so for 5 years. Diet was ruled out as
the cause of iron deficiency.
The haematological parameters indicated that the geophagic group (43%) were
inclined to have hypochromic microcytic anaemia, while a small percentage of
control groups (8%) had HMA; this was revealed by the red cell parameters and red
cell indices. In addition, the odds ratio for the haematological results revealed that
the probability of a geophagic person developing anaemia was two times greater
than that of a non-geophagic person. Platelet results partially ruled out bleeding as
a cause of anaemia. The median red cell distribution width indicated that the
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geophagic group was inclined to have anisocytosis. The geophagic group was
found to have iron deficiency (75%), whilst the control group had a small
percentage with iron deficiency (22%), which was validated by the serum ferritin,
serum iron and saturated transferrin (chemical analysis). The odds ratio revealed
that the probability of a geophagic person being iron deficient is 3 times greater
than that of a non-geophagic person. The strongest association is seen with iron
study findings, because being iron deficient showed the highest odd ratio than the
association with red cell morphology and even haemoglobin. Thus, participants
were more iron deficient than suffering from iron deficiency anaemia.
Inflammatory and parasitic indicators proved that inflammation and infection was
uncommon in both groups, and therefore did not compromise the credibility of the
iron study results. Inflammatory indicators (white blood cells, erythrocyte
sedimentation rate and C-reactive protein) ruled out inflammation, whilst eosinophil
count showed no indication of parasitic infection for both geophagic and control
groups.
To conclude, the study found that an association exists between geophagia and
haematological parameters of iron deficiency anaemia amongst geophagic women
in Qwa-Qwa, in that geophagic material contributes to iron deficiency anaemia.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:cut/oai:ir.cut.ac.za:11462/239 |
| Date | January 1900 |
| Creators | Raphuthing, Manneheng. Violet. |
| Contributors | Brand, C.E., Central University of Technology, Free State. Department of Health Science |
| Publisher | Bloemfontein: Central University of Technology, Free State |
| Source Sets | South African National ETD Portal |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
| Format | 10 143 195 bytes, 1 file, Application/PDF |
| Rights | Central University of Technology, Free State |
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