Prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan: a cross-sectional study

J Eat Disord. 2023 Mar 27;11(1):49. doi: 10.1186/s40337-023-00777-0.

Abstract

Background: Pica, the craving for and purposive eating of non-food items, is a common worldwide problem, especially among children and pregnant women. There are few published data on pica among adolescents in sub-Saharan Africa, and no study has been carried- out in Sudan. This study was conducted to determine the prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan.

Methods: A school‑based cross‑sectional study was conducted from July to September 2022 among adolescent students (aged 10-19 years) in four public primary and secondary schools in Almatamah locality in north Sudan. Sociodemographic information (age, sex, mother's education, mother's occupation, and father's education) was collected through a questionnaire. Weight and height were measured using a standard procedure, and the body mass index Z-score was computed using the World Health Organization's reference values. Logistic regression analysis was performed.

Results: Of the 384 enrolled adolescents, 180 (46.9%) were male and 204 (53.1%) were female. Their median (interquartile range) age was 15.1 (13.1‒16.3) years. The prevalence of symptoms of pica was found to be 30.7%, accounting for 118 adolescents. The most common type of pica was geophagia (eating clay and sand; 102 adolescents, 86.4%), followed by pagophagia (eating ice; 14 adolescents, 11.8%) and flour (starch; two adolescents, 1.6%). In the logistic regression analysis, females (adjusted odds ratio = 3.52, 95% confidence interval (CI) = 2.15‒5.78) and a lower level of father's education (adjusted odds ratio = 2.05, 95% CI = 1.26‒3.34) were associated with symptoms of pica.

Conclusion: In Sudan, symptoms of pica are common among adolescents, especially females. Caregivers need to assess pica in adolescents. Further research is needed to develop guidelines, medical training, and practice.

Keywords: Adolescent; Associated factors; Geophagy; Pica; Sudan.

Plain language summary

We conducted this study from July to September 2022 to estimate the rate of adolescents who would eat non-food items (pica) in Sudan. We gathered sociodemographic characteristics through a questionnaire. Of the 384 enrolled adolescents, 180 (46.9%) were male and 204 (53.1%) were female. We found that 118 (30.7%) adolescents would eat non-food items (pica) and that the most common type was eating clay and sand (102 adolescents, 86.4%), followed by eating ice (14 adolescents, 11.8%) and flour (starch; 2 adolescents, 1.6%). Females and those with a lower level of father’s education were likely to eat non-food items.