Planning grant: developing the research capacity to investigate the practice of geophagy among pregnant mothers and impacts on children's neurodevelopment

The National Institutes of Health Fogarty International Center awarded Oregon State University $411,115 under the International Research and Research Training program (CFDA 93.989) on September 15, 2025, to develop research capacity investigating geophagy—the ingestion of earth—among pregnant mothers in Zambia and its impacts on children's neurodevelopment.

The planning grant supports four specific aims: training researchers at the Tropical Diseases Research Centre (TDRC) and Copperbelt University, School of Medicine (CBU-SOM) in Ndola, Zambia, to assess children's neurodevelopment using the Bayley Scales of Infant and Toddler Development, 4th Edition; enrolling 200 HIV-negative peripartum mothers to assess geophagy practice, maternal heavy metal exposure (lead, arsenic, and manganese), and impacts on children's neurodevelopment at 12 months of age; determining whether gut microbiota community structure differs between geophagous and non-geophagous mothers using 16S rRNA gene profiling; and developing alternatives to geophagy during pregnancy in consultation with an advisory board of Zambian public health practitioners.

Work is performed in Oregon, USA, with collaboration at partner institutions in Ndola, Zambia. The period of performance runs from September 15, 2025, to June 30, 2027. Sub-recipients are the Tropical Diseases Research Centre and Copperbelt University, each receiving sub-award notice on January 30, 2026, to support the research capacity-building and field enrollment activities.

Abstract

Pica is the craving for and deliberate consumption of nonfood items. Geophagy is the ingestion of earth, one of the most common forms of pica. Geophagy is more prevalent among pregnant mothers in sub- saharan africa, with reported rates ranging up to 87%. Pica, including the practice of geophagy, has also been documented in the USA; however, the rate of geophagy is lower compared to sub-saharan africa. Maternal ingestion of soil/clay potentially exposes the developing fetus to dangerous levels of heavy metals, including lead, arsenic, and manganese, which are known to adversely impact children's neurodevelopment. Moreover, maternal ingestion of soil/clay may diminish the capacity of the GUT microbiota to perform critical functions, which (directly or indirectly) impact fetal brain development. This planning grant will strengthen the collaboration between oregon state university and two institutions in ndola, zambia, including the tropical diseases research centre (TDRC) and copperbelt university, school of medicine (CBU-SOM). Aim 1. To the best of our knowledge, the expertise to assess children's neurodevelopment is lacking in ndola, zambia. Researchers at the TDRC and CBU-SOM will be trained to assess children's neurodevelopment using the bayley scales of infant development, 4TH edition (BSID-4). Aim 2. Among 200 HIV-negative mothers/offspring enrolled at parturition, we will assess the practice of geophagy, maternal exposure to heavy metals, and impacts of maternal geophagy on children's neurodevelopment at 12-months of age using BSID-4. Aim 3. Among enrolled mothers, we will determine whether the community structure of the GUT microbiota differs between geophageous and non-geophageous mothers using 16S rrna gene profiling. Aim 4. Working with an advisory board comprised of zambian public health practitioners, we will investigate sustainable alternatives to the practice of geophagy. Potential interventions will be tested in a larger cohort of pregnant mothers in the full study. This study will increase the capacity of both institutions in ndola, zambia, to conduct environmental health research and assess children's neurodevelopment. The long-term goal of this study is to reduce the practice of geophagy among pregnant mothers, by conducting evidence-based research to inform public health officials concerning the risks of geophagy. Because mothers pass down this practice to their children, reducing maternal ingestion of soil/clay will also likely reduce this practice among their children. The results from this study are applicable to the USA population, where geophagy has also been documented