Child soil ingestion in rural Ghana – frequency, caregiver perceptions, relationship with household floor material and associations with child diarrhoea

Valerie Bauza, Diana M. Byrne, John T. Trimmer, Amanda Lardizabal, Philip Atiim, Mawuli A.K. Asigbee, Jeremy S. Guest

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objectives: The objectives of this work were to evaluate (i) the prevalence and frequency of caregiver-reported soil ingestion by children, (ii) whether household flooring material in the bedroom (earth vs. concrete) affected caregiver-reported soil ingestion, (iii) whether caregiver-reported soil ingestion was associated with caregiver-reported diarrhoea and (iv) caregivers’ perceptions of their children ingesting soil. Methods: We conducted 309 household surveys in northern Ghana, including 529 children under five (249 children aged 6–36 months), and measured faecal contamination in soil from 31 households. Results: Among all children, 15% were reported to have directly ingested soil in the past week, including 28% of children aged 6–36 months. Among children reported to have ingested soil, the median frequency was 14 times in the past week, and the median amount of soil ingested each time was half a handful. There was no association between household floor material and whether the caregiver observed a child directly ingesting soil. After adjusting for household floor material and other potential confounding variables, caregiver-reported soil ingestion was associated with caregiver-reported diarrhoea for children under five [adjusted odds ratio (adj. OR) = 3.13, 95% confidence interval (CI) 2.76–3.55] and children aged 6–36 months (adj. OR = 2.61, 95% CI 2.01–3.39). Approximately 83% of caregivers whose children ingested soil reported they thought it was unsafe and were more likely to report stopping their child from ingesting soil, but these responses did not affect the quantity of soil ingested. Conclusions: Our results suggest direct soil ingestion is associated with diarrhoea independent of household floor material, and separate interventions may be necessary to prevent exploratory soil ingestion.

Original languageEnglish
Pages (from-to)558-569
Number of pages12
JournalTropical Medicine and International Health
Issue number5
StatePublished - May 2018

Bibliographical note

Funding Information:
We thank David Sombie and Emmanuel Osei-Mensah at Catholic Relief Services for their help training enumerators and coordinating fieldwork, the enumerators for conducting household interviews, and the village leaders and participating households who made this study possible. We also thank Dr. Stephen Nutsugah, Dr. Roger Kanton, Dr. Askia Mohammed and Prosper Amenuvor at the Savanna Agricultural Research Institute for providing laboratory space and assistance, and Dr. Kathleen Ragsdale, Dr. Mary Read-Wahidi and Audrey Reid at Mississippi State University for providing data that assisted with preliminary site scoping. This research is in part funded by the United States Agency for International Development (USAID) Feed the Future Lab for Soybean Value Chain Research. The award number is Cooperative Agreement Number AID-OAA-L-14-00001. Valerie Bauza was supported by the National Science Foundation Graduate Research Fellowship Program under grant no. DGE-1144245, Diana Byrne was funded by the Department of Civil and Environmental Engineering at University of Illinois at Urbana-Champaign (UIUC), John Trimmer was funded by the Illinois Distinguished Fellowship at the UIUC and Amanda Lardizabal was partially supported by USAID.

Publisher Copyright:
© 2018 John Wiley & Sons Ltd


  • diarrhoeal disease
  • floor upgrade
  • geophagy
  • low income
  • soil ingestion

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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