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Characteristics of Pica Behavior among Mothers around Lake Victoria, Kenya: A Cross-Sectional Study

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435, USA
Ekialo Kiona Research Dept, Organic Health Response, Mbita, P.O. Box 224-40305, Kenya
Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, UCSF, 1001 Potrero Ave, San Francisco, CA 94110, USA
Department of Family Medicine and Community Health, University of Minnesota, 5516 Delaware St SE, Minneapolis, MN 55455, USA
Bureau for Global Health, USAID, Washington, DC 20001, USA
Centre for Microbiology Research, Kenya Medical Research Institute, Hospital Road, Nairobi 00100, Kenya
Department of Environmental Science, Policy, and Management, University of California, Berkeley, 130 Mulford Hall #3114, Berkeley, CA 94720, USA
Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA
Division of Community Health Sciences, School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA 94720-7360, USA
Master of Public Health Program, Department of Population Medicine and Diagnostic Sciences, Cornell University, S2-004 Shurman Hall, Ithaca, NY 14853, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(14), 2510;
Received: 3 May 2019 / Revised: 8 July 2019 / Accepted: 10 July 2019 / Published: 14 July 2019
(This article belongs to the Section Global Health)
Background: Pica, the craving and purposeful consumption of nonfoods, is poorly understood. We described the prevalence of pica among women on Mfangano Island, Kenya, and examined sociodemographic and health correlates. Methods: Our cross-sectional study included 299 pregnant or postpartum women in 2012. We used a 24-h recall to assess pica, defined as consumption of earth (geophagy), charcoal/ash, or raw starches (amylophagy) and built multivariable logistic regression models to examine sociodemographic and health correlates of pica. Results: Eighty-one women (27.1%) engaged in pica in the previous 24 h, with 59.3% reporting amylophagy and 56.8% reporting geophagy, charcoal, and/or ash consumption. The most common substances consumed were raw cassava (n = 30, 36.6%), odowa, a chalky, soft rock-like earth (n = 21, 25.6%), and soil (n = 17, 20.7%). Geophagy, charcoal, and/or ash consumption was negatively associated with breastfeeding (OR = 0.38, 95% CI: 0.18–0.81), and amylophagy was associated with pregnancy (OR = 4.31, 95% CI: 1.24–14.96). Pica was more common within one of six study regions (OR = 3.64, 95% CI: 1.39–9.51). We found no evidence of an association between food insecurity and pica. Conclusion: Pica was a common behavior among women, and the prevalence underscores the need to uncover its dietary, environmental, and cultural etiologies. View Full-Text
Keywords: pica; geophagy; amylophagy; pregnancy; breastfeeding; Kenya pica; geophagy; amylophagy; pregnancy; breastfeeding; Kenya
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Chung, E.O.; Mattah, B.; Hickey, M.D.; Salmen, C.R.; Milner, E.M.; Bukusi, E.A.; Brashares, J.S.; Young, S.L.; Fernald, L.C.; Fiorella, K.J. Characteristics of Pica Behavior among Mothers around Lake Victoria, Kenya: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2019, 16, 2510.

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