AIDS and Behavior

, Volume 21, Issue 12, pp 3630–3635 | Cite as

Factors Associated with Geophagy and Knowledge About Its Harmful Effects Among Native Sub-Saharan African, Caribbean and French Guiana HIV Patients Living in Northern France

  • Isabelle Kmiec
  • Yohan Nguyen
  • Christine Rouger
  • Jean Luc Berger
  • Dorothée Lambert
  • Maxime Hentzien
  • Delphine Lebrun
  • Ailsa Robbins
  • Moustapha Drame
  • Firouzé Bani-Sadr
Brief Report


Geophagy, or the ingestion of earth or clay, is widespread among women of Sub-Saharan African, Caribbean or French Guiana origin. Little is known about this practice among HIV patients native of these countries and who are followed-up in France. The aims of this study were to determine (i) the prevalence and factors associated with geophagy among HIV patients native of these countries, (ii) patients’ knowledge about the harmful effects of geophagy, and (iii) the association of geophagy with iron deficiency, or a history of anemia or constipation. Among the 119 included patients, current geophagy and previous geophagy were present in 11/119 (9%) and 47/119 (40%) patients, respectively. Female gender was the only factor associated with consumption (OR 5.37; 95% CI 2.07–15.92 p = 0.001). Awareness about the risk of iron-deficient anemia was low (24%). Preventive education should be integrated into the care of HIV adults from countries in which geophagy is a culture and widely accepted practice.


HIV infection Geophagy Pica Iron deficiency Anemia Feeding and eating disorders 


La geofagia, o la ingestión de tierra o arcilla, es conocida entre las mujeres originarias de África Subsahariana, el Caribe o la Guyana Francesa. Poco se sabe sobre esta práctica entre los pacientes HIV originarios de estos países y que tienen un seguimiento médico en Francia. Los objetivos de este estudio eran de determinar (i) la prevalencia y los factores asociados a la geofagia entre pacientes HIV originarios de estos países, (ii) los conocimientos acerca de los efectos nocivos de la geofagia y (iii) la asociación de geofagia con la carencia en hierro, o un antecedente de anemia o de constipación. Dentro de los 119 pacientes incluidos, 11/119 (9%) presentaban una geofagia actual, y 47/119 (40%) presentaban una geofagia pasada. El género femenino fue el único factor asociado con geofagia (OR=5.37; 95% CI = 2.07-15.92; p = 0.001). El conocimiento acerca del riesgo de desarrollar una anemia por carencia en hierro era bajo (24%). La educación preventiva debería ser integrada en los cuidados de pacientes adultos HIV originarios de los países en los cuales la geofagia es una práctica cultural arraigada ampliamente aceptada.


Authors Contributions

All authors participated in the design of the study protocol and data collection. IK performed the data management. YN and MD performed statistical analyses. YN and FBS wrote the first manuscript draft. All authors participated in interpretation of the data and writing of the final manuscript and all authors approved the final manuscript. IK and FBS were responsible for the overall supervision of the study.

Compliance with Ethical Standards

Conflict of interest

None for all authors.

Informed Consent

All subjects gave informed consent to participate to the study.

Research Involving Human Participants

The study was approved by the Reims University Hospital IRB under the number 2013–19.


  1. 1.
    Kawai K, Saathoff E, Antelman G, Msamanga G, Fawzi WW. Geophagy (soil-eating) in relation to anemia and helminth infection among HIV-infected pregnant women in Tanzania. Am J Trop Med Hyg. 2009;80(1):36–43.PubMedGoogle Scholar
  2. 2.
    Young SL, Khalfan SS, Farag TH, Kavle JA, Ali SM, Hajji H, et al. Association of pica with anemia and gastrointestinal distress among pregnant women in Zanzibar, Tanzania. Am J Trop Med Hyg. 2010;83(1):144–51.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Njiru H, Elchalal U, Paltiel O. Geophagy during pregnancy in Africa: a literature review. Obstet Gynecol Surv. 2011;66(7):452–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Woywodt A, Kiss A. Geophagia: the history of earth-eating. J R Soc Med. 2002;95(3):143–6.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Lambert V, Pouget K, Basurko C, Boukhari R, Dallah F, Carles G. Geophagy and pregnancy: current knowledge and management. Clinical experiences of an obstetrical department in French Guiana. J Gynécol Obstét Biol Reprod. 2014;43(7):496–503.CrossRefGoogle Scholar
  6. 6.
    Lambert V, Boukhari R, Nacher M, Goullé J-P, Roudier E, Elguindi W, et al. Plasma and urinary aluminum concentrations in severely anemic geophagous pregnant women in the Bas Maroni region of French Guiana: a case-control study. Am J Trop Med Hyg. 2010;83(5):1100–5.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Wong MS, Bundy DA, Golden MH. Quantitative assessment of geophagous behaviour as a potential source of exposure to geohelminth infection. Trans R Soc Trop Med Hyg. 1988;82(4):621–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Thihalolipavan S, Candalla BM, Ehrlich J. Examining pica in NYC pregnant women with elevated blood lead levels. Matern Child Health J. 2013;17(1):49–55.CrossRefPubMedGoogle Scholar
  9. 9.
    Narayanan SK, Akbar Sherif VS, Babu PR, Nandakumar TK. Intestinal obstruction secondary to a colonic lithobezoar. J Pediatr Surg. 2008;43(7):e9–10.CrossRefPubMedGoogle Scholar
  10. 10.
    Gulum M, Yeni E, Savas M, Sahin MA, Kati M. A pica case confused with renal and bladder stones. J Pak Med Assoc. 2012;62(12):1340–1.PubMedGoogle Scholar
  11. 11.
    Anderson JE, Akmal M, Kittur DS. Surgical complications of pica: report of a case of intestinal obstruction and a review of the literature. Am Surg. 1991;57(10):663–7.PubMedGoogle Scholar
  12. 12.
    Saathoff E, Olsen A, Kvalsvig JD, Geissler PW. Geophagy and its association with geohelminth infection in rural schoolchildren from northern KwaZulu-Natal, South Africa. Trans R Soc Trop Med Hyg. 2002;96(5):485–90.CrossRefPubMedGoogle Scholar
  13. 13.
    Glickman LT, Camara AO, Glickman NW, McCabe GP. Nematode intestinal parasites of children in rural Guinea, Africa: prevalence and relationship to geophagia. Int J Epidemiol. 1999;28(1):169–74.CrossRefPubMedGoogle Scholar
  14. 14.
    Bruhn CM, Pangborn RM. Reported incidence of pica among migrant families. J Am Diet Assoc. 1971;58(5):417–20.PubMedGoogle Scholar
  15. 15.
    Vermeer DE, Frate DA. Geophagia in rural Mississippi: environmental and cultural contexts and nutritional implications. Am J Clin Nutr. 1979;32(10):2129–35.PubMedGoogle Scholar
  16. 16.
    Sayers G, Lipschitz DA, Sayers M, Seftel HC, Bothwell TH, Charlton RW. Relationship between pica and iron nutrition in Johannesburg Black adults. South Afr Med J. 1974;48(39):1655–60.Google Scholar
  17. 17.
    Miao D, Young SL, Golden CD. A meta-analysis of pica and micronutrient status. Am J Hum Biol. 2014;27:84–93.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Boybeyi O, Albayrak M, Aslan MK, Soyer T. Colonic lithobezoar: a rare cause of partial intestinal obstruction. Turk J Pediatr. 2013;55(1):104–6.PubMedGoogle Scholar
  19. 19.
    Kelly NR, Shank LM, Bakalar JL, Tanofsky-Kraff M. Pediatric feeding and eating disorders: current state of diagnosis and treatment. Curr Psychiatry Rep. 2014;16(5):446.CrossRefPubMedGoogle Scholar
  20. 20.
    Ceschin L, Giannunzio V, Favaro A, Santonastaso P. Pica in an eating disordered woman with multiple sclerosis: impulse dys-control, compulsive symptom or self-medication attempt? Eat Weight Disord. 2010;15(1–2):e116–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Bhatia MS, Gupta R. Pica responding to SSRI: an OCD spectrum disorder? World J Biol Psychiatry. 2009;10(4 Pt 3):936–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Isabelle Kmiec
    • 1
  • Yohan Nguyen
    • 1
    • 2
  • Christine Rouger
    • 1
  • Jean Luc Berger
    • 1
  • Dorothée Lambert
    • 1
  • Maxime Hentzien
    • 1
  • Delphine Lebrun
    • 1
  • Ailsa Robbins
    • 1
  • Moustapha Drame
    • 3
    • 4
  • Firouzé Bani-Sadr
    • 1
    • 2
  1. 1.CHU Reims, Unité des Maladies Infectieuses et Tropicales, Hôpital Robert DebréUniversité Champagne-ArdenneReimsFrance
  2. 2.Faculté de MédecineUniversité de Reims Champagne-ArdenneReimsFrance
  3. 3.CHU Reims, Hôpital Robert Debré, Pôle Recherche et InnovationsUnité d’aide MéthodologiqueReimsFrance
  4. 4.Faculté de MédecineUniversité de Reims Champagne-ArdenneReimsFrance

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