Pica Practices among Apparently Healthy Women and Their Young Children in Ghana

Abstract

Background: Pica is an increased appetite/craving for food or non-food substances like clay, and chalk, and is strongly associated with iron deficiency (ID) anemia. This study assessed pica practices among non-pregnant mothers and their children, 12-to-59 months, in an anaemia endemic population in Ghana.

Subjects and methods: A cross-sectional quantitative survey was conducted in two randomly selected districts in Northern Ghana. The researchers developed semi-structured questionnaires with components on pica practice, history and experiences and administered via structured face-to-face interviews with mothers (N=161) and all their children 6-59 months. Of this population, 132 mothers had children 12-to-59 months (N=139) in April 2012. Pica practice among children was reported by their mothers. Data was analysed using SPSS version 23.0.

Results: Few mothers (3%) spontaneously reported pica (for uncommon food and/or non-food substances) at the time of the interview, however, 16 (12.1%) mothers with pica were confirmed after further probing. Twelve (8.6%) children were reported to have ingested/craved clay/soil/dust (11 / 91.7 %), paper (1 / 7.1%) and chalk (1/7.1%) prior to the interview. One child had poly-pica (pica for two substance). Pica was reported to have been practised by expecting mothers during 37 (26.6%) of the pregnancies of the children involved in the study, and was mostly for clay/soil (33 / 89.1%), kola nut (5 / 3.6%), uncooked rice and bambara beans. Children's pica practices were significantly associated (χ²=6.33; p=0.011) with their mothers' pica practices during pregnancy as well as with mothers' pica practices at the time of the study (χ²=5.98; p=0.035). A logistic regression analysis seemed to show that pica of the mother during pregnancy was more strongly associated with the child's pica than later pica behaviour of the mother. Many myths and misconceptions associated with the practice of pica were also reported in these communities.

Conclusions: The reported pica practice among mothers and their children was lower than what has been observed in other studies. Knowledge and perceptions regarding pica were mostly inaccurate. Education on pica and associated dangers of its practices should be included in nutrition interventions in communities with known high anemia prevalence.

Keywords: Apparently healthy; Iron deficiency; Northern Ghana; mothers and children; pica practices.