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Ashraf W, Rehman A, Rabbani M, Shaukat W, Wang JS. Aflatoxins posing threat to food safety and security in Pakistan: Call for a one health approach. Food Chem Toxicol 2023; 180:114006. [PMID: 37652127 DOI: 10.1016/j.fct.2023.114006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/26/2023] [Accepted: 08/26/2023] [Indexed: 09/02/2023]
Abstract
Aflatoxins are among the most important mycotoxins due to their widespread occurrence and adverse impacts on humans and animals. These toxins and/or their metabolites cannot be destroyed with cooking or boiling methods. Therefore, consumption of aflatoxin-contaminated food may lead to impaired growth, compromised immunity, stomach and liver cancer, and acute toxicity. These adverse effects along with food wastage might have detrimental consequences on a country's economy. Several studies from Pakistan reported a high prevalence of aflatoxins in food and feed commodities (Range; milk = 0.6-99.4%, cereals, and grains = 0.38-41%, animal feed = 31-100%). Notably, Pakistan reported very high figures of impaired child growth-stunted 40.2%, wasted 17.7% and underweight 28.9%-that could be associated with the higher aflatoxin prevalence in food items. Importantly, high aflatoxins prevalence, i.e. 100%, 69% and 60.5%, in children has been reported in Pakistan. Food and feed are more prone to aflatoxin contamination due to Pakistan's hot and humid climate; however, limited awareness, inadequate policy framework, and weak implementation mechanisms are the major obstacles to effective control. This review will discuss aflatoxins prevalence, associated risk factors, adverse health effects, required regulatory regime, and effective control strategies adopting the One Health approach to ensure food safety and security.
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Affiliation(s)
- Waseela Ashraf
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences Lahore, 54000, Pakistan; Department of Environmental Health Science, The University of Georgia, Athens, GA, USA; Health Services Academy, Islamabad, 44000, Pakistan
| | - Abdul Rehman
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences Lahore, 54000, Pakistan.
| | - Masood Rabbani
- Institute of Microbiology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Waseem Shaukat
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, T2N4N1, Alberta, Canada
| | - Jia-Sheng Wang
- Department of Environmental Health Science, The University of Georgia, Athens, GA, USA
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Al-Shaarani AAQA, Quach ZM, Wang X, Muafa MHM, Nafis MMH, Pecoraro L. Analysis of Airborne Fungal Communities on Pedestrian Bridges in Urban Environments. Microorganisms 2023; 11:2097. [PMID: 37630657 PMCID: PMC10458245 DOI: 10.3390/microorganisms11082097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Airborne fungal spores constitute an important type of bioaerosol and are responsible for a number of negative effects on human health, including respiratory diseases and allergies. We investigated the diversity and concentration of culturable airborne fungi on pedestrian bridges in Tianjin, China, using an HAS-100B air sampler. We compared the airborne fungal communities at the top central area of the selected pedestrian bridges and along the corresponding sidewalk, at ground level. A total of 228 fungal strains belonging to 96 species and 58 genera of Ascomycota (68.86%), Basidiomycota (30.26%), and Mucoromycota (0.88%) were isolated and identified using morphological and molecular analysis. Alternaria was the dominant genus (20.61%), followed by Cladosporium (11.48%), Schizophyllum (6.14%), Sporobolomyces (5.70%), and Sporidiobolus (4.82%). Alternaria alternata was the most frequently occurring fungal species (6.58%), followed by Schizophyllum commune (5.26%), Alternaria sp. (4.82%), Sporobolomyces carnicolor (4.39%), and Cladosporium cladosporioides (3.95%). The recorded fungal concentration ranged from 10 to 180 CFU/m3. Although there was no significant difference in the distribution and abundance of the dominant airborne fungal taxa between the two investigated bridges' sites, numerous species detected with a low percentage of abundance belonging to well-known pathogenic fungal genera, including Alternaria, Aspergillus, Aureobasidium, Cladosporium, Penicillium, and Trichoderma, were exclusively present in one of the two sites. The relative humidity showed a stronger influence compared to the temperature on the diversity and concentration of airborne fungi in the investigated sites. Our results may provide valuable information for air quality monitoring and for assessing human health risks associated with microbial pollution.
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Affiliation(s)
| | | | | | | | | | - Lorenzo Pecoraro
- School of Pharmaceutical Science and Technology, Tianjin University, 92 Weijin Road, Tianjin 300072, China; (A.A.Q.A.A.-S.); (Z.M.Q.); (X.W.); (M.H.M.M.); (M.M.H.N.)
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Bastos-Amador P, Duarte EL, Torres J, Caldeira AT, Silva I, Salvador C, Assunção R, Alvito P, Ferreira M. Maternal dietary exposure to mycotoxin aflatoxin B 1 promotes intestinal immune alterations and microbiota modifications increasing infection susceptibility in mouse offspring. Food Chem Toxicol 2023; 173:113596. [PMID: 36603704 DOI: 10.1016/j.fct.2022.113596] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
Mycotoxins are secondary metabolites produced by fungi occurring in food that are toxic to animals and humans. Early-life mycotoxins exposure has been linked to diverse pathologies. However, how maternal exposure to mycotoxins impacts on the intestinal barrier function of progeny has not been explored. Here, exposure of pregnant and lactating C57Bl/6J female mice to aflatoxin B1 (AFB1; 400 μg/kg body weight/day; 3 times a week) in gelatine pellets, from embryonic day (E)11.5 until weaning (postnatal day 21), led to gut immunological changes in progeny. The results showed an overall increase of lymphocyte number in intestine, a reduction of expression of epithelial genes related to microbial defence, as well as a decrease in cytokine production by intestinal type 2 innate lymphoid cells (ILC2). While susceptibility to chemically induced colitis was not worsened, immune alterations were associated with changes in gut microbiota and with a higher vulnerability to infection by the protozoan Eimeria vermiformis at early-life. Together these results show that maternal dietary exposure to AFB1 can dampen intestinal barrier homeostasis in offspring decreasing their capability to tackle intestinal pathogens. These data provide insights to understand AFB1 potential harmfulness in early-life health in the context of intestinal infections.
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Affiliation(s)
- Patricia Bastos-Amador
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016, Lisbon, Portugal; Champalimaud Foundation, Champalimaud Centre for the Unknown, 1400-038, Lisbon, Portugal
| | - Elsa Leclerc Duarte
- University of Évora, School of Science and Technology, 7000-671, Évora, Portugal; MED-Mediterranean Institute for Agriculture, Environment and Development, 7006-554, Évora, Portugal
| | - Júlio Torres
- University of Coimbra, Center for Innovative Biomedicine and Biotechnology, Center for Neuroscience and Cell Biology, 3004-504, Coimbra, Portugal
| | | | - Inês Silva
- University of Évora, School of Science and Technology, 7000-671, Évora, Portugal; MED-Mediterranean Institute for Agriculture, Environment and Development, 7006-554, Évora, Portugal; HERCULES Laboratory, Universidade de Évora, 7000-809, Évora, Portugal
| | - Cátia Salvador
- HERCULES Laboratory, Universidade de Évora, 7000-809, Évora, Portugal
| | - Ricardo Assunção
- IUEM, Instituto Universitário Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior, CRL, 2829 - 511, Caparica, Portugal; University of Aveiro, CESAM - Centre for Environmental and Marine Studies, 3810-193, Aveiro, Portugal
| | - Paula Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016, Lisbon, Portugal; University of Aveiro, CESAM - Centre for Environmental and Marine Studies, 3810-193, Aveiro, Portugal
| | - Manuela Ferreira
- Champalimaud Foundation, Champalimaud Centre for the Unknown, 1400-038, Lisbon, Portugal; University of Coimbra, Center for Innovative Biomedicine and Biotechnology, Center for Neuroscience and Cell Biology, 3004-504, Coimbra, Portugal.
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Wangia-Dixon RN, Quach THT, Song X, Ombaka J, Githanga DP, Anzala OA, Wang JS. Determinants of aflatoxin exposures in Kenyan School-aged children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1183-1191. [PMID: 33256462 DOI: 10.1080/09603123.2020.1854192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/18/2020] [Indexed: 06/12/2023]
Abstract
Aflatoxins are naturally occurring food toxins known to contaminate cereals with a carry-over effect in milk and meat products from farm animals raised on contaminated feed. In children, continuous consumption of aflatoxin-contaminated food is linked to immune suppression, vaccine interference and growth faltering while in adult populations, carcinogenesis in the liver has been established. We evaluate the main determinants of aflatoxin exposures among children recruited from primary schools in Makueni and Siaya Counties. A five-part questionnaire was administered to collect information from randomly selected participants. AflatoxinB1-lysine adducts in children's sera and total aflatoxins in food samples were analyzed by High-Performance Liquid Chromatography with Fluorescence detection. Using Chi-squared tests and Kruskal-Wallis tests, children from low-income households had the highest aflatoxin exposure, p-value = 0.0029. Smaller family size, greater food diversity, and good farming practices were associated with low aflatoxin exposures p < 0.001. Individual households living under severe levels of poverty were evidently exposed to higher levels of aflatoxins.
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Affiliation(s)
- Ruth Nabwire Wangia-Dixon
- Department of Environmental Health Science, University of Georgia, Athens, USA
- KAVI Institute of Clinical Research, University of Nairobi, Nairobi, Kenya
| | - Trang Ho Thu Quach
- Faculty of Pharmacy, Ho Chi Minh City University of Technology (HUTECH), Vietnam
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, USA
| | - Xiao Song
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, USA
| | - James Ombaka
- School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - David Peter Githanga
- Nairobi Hospital, Hospital Road, Nairobi, Kenya
- Medical Microbiology Department, University of Nairobi Nairobi, Kenya
| | - Omu Aggrey Anzala
- KAVI Institute of Clinical Research, University of Nairobi, Nairobi, Kenya
- Nairobi Hospital, Hospital Road, Nairobi, Kenya
- Medical Microbiology Department, University of Nairobi Nairobi, Kenya
| | - Jia-Sheng Wang
- Department of Environmental Health Science, University of Georgia, Athens, USA
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Lei L, Liu S, Ye Y, Qiu X, Huang D, Pan D, Chen J, Qian Z, McMillin SE, Vaughn MG, Luo X, Wu K, Xiao S, Li J, Liu M, Yang Y, Lai M, Dong G, Zeng X. Associations between Serum Aflatoxin-B1 and Anemia in Pregnant Women: Evidence from Guangxi Zhuang Birth Cohort in China. Toxins (Basel) 2021; 13:toxins13110806. [PMID: 34822590 PMCID: PMC8618761 DOI: 10.3390/toxins13110806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 12/21/2022] Open
Abstract
Aflatoxin B1 (AFB1) is a common toxic mycotoxin and is detectable in pregnant women. Animal studies have revealed that AFB1 caused the lysis of erythrocytes and a decrease in hemoglobin. We conducted a prospective cohort study in Guangxi, China, in order to evaluate the association between AFB1 exposure and anemia in pregnant women during the entire pregnancy. A total of 616 pregnant women from the Guangxi Zhuang Birth Cohort were included in the study. Serum AFB1-albumin (AFB1-ALB) adduct levels were measured. The effect of AFB1-ALB adducts on hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were analyzed by using multivariable linear regression. The risks of anemia from AFB1-ALB adduct exposure were assessed by multivariable logistic regression. We found that the AFB1-ALB adduct was significantly associated with a decrease in Hb (β = −4.99, 95% CI: −8.42, −1.30), MCV (β = −4.58, 95% CI: −7.23, −1.94), MCH (β = −1.86, 95% CI: −2.87, −0.85), and MCHC (β = −5.23, 95% CI: −8.28, −2.17) in the first trimester with the third tertile of AFB1-ALB adducts when compared with the first tertile. Furthermore, the third tertile of the AFB1-ALB adduct significantly increased the risk of anemia by 2.90 times than compared to the first tertile in the first trimester (OR = 3.90, 95% CI: 1.67, 9.14). A significant positive does–response relationship existed between AFB1-ALB adduct levels and anemia risk (Ptrend = 0.001). When dividing anemia types, we only found that the third tertile of AFB1-ALB adduct increased the risk of microcytic hypochromic anemia (MHA) in the first trimester (OR = 14.37, 95% CI: 3.08, 67.02) and second trimester (OR = 4.75, 95% CI: 1.96, 11.51). These findings demonstrate the correlation between maternal AFB1 exposure during early pregnancy and risk of anemia, especially MHA, and during different trimesters in Southern China. More efforts should be made to diminish AFB1 exposure for pregnant women.
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Affiliation(s)
- Lei Lei
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Shun Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, Nanning 530021, China;
| | - Ye Ye
- Center for Disease Control and Prevention, Guangxi Liuzhou Iron & Steel Group Co., Ltd., Liuzhou 545002, China;
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China;
| | - Dongxiang Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Jiehua Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA;
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA; (S.E.M.); (M.G.V.)
| | - Michael G. Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA; (S.E.M.); (M.G.V.)
| | - Xingxi Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Kaili Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Suyang Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Jinxiu Li
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Meiliang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Yu Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Mingshuang Lai
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
| | - Guanghui Dong
- Department of Environmental and Occupational Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Correspondence: (G.D.); (X.Z.)
| | - Xiaoyun Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China; (L.L.); (X.Q.); (D.P.); (J.C.); (X.L.); (K.W.); (S.X.); (J.L.); (M.L.); (Y.Y.); (M.L.)
- Correspondence: (G.D.); (X.Z.)
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Ortega-Beltran A, Bandyopadhyay R. Contributions of integrated aflatoxin management strategies to achieve the sustainable development goals in various African countries. GLOBAL FOOD SECURITY 2021. [DOI: 10.1016/j.gfs.2021.100559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Ismail A, Naeem I, Gong YY, Routledge MN, Akhtar S, Riaz M, Ramalho LNZ, de Oliveira CAF, Ismail Z. Early life exposure to dietary aflatoxins, health impact and control perspectives: A review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa. Sci Rep 2021; 11:1619. [PMID: 33452336 PMCID: PMC7810982 DOI: 10.1038/s41598-020-80356-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/27/2020] [Indexed: 12/02/2022] Open
Abstract
Numerous population-based studies have documented high prevalence of aflatoxin associated childhood stunting in low income countries. We provide an estimate of the disease burden of aflatoxin related stunting using data from the four African countries. For this empirical analysis, we obtained blood aflatoxin albumin adduct biomarker based exposure data as measured using ELISA technique and anthropometric measurement data from surveys done over a 12-year period from 2001 to 2012 in four low income countries in Africa. We used these data to calculate population attributable risk (PAR), life time disease burden for children under five by comparing two groups of stunted children using both prevalence and incidence-based approaches. We combined prevalence estimates with a disability weight, measuring childhood stunting and co-occurrence of stunting-underweight to produce years lived with disability. Using a previously reported mortality, years of life lost were estimated. We used probabilistic analysis to model these associations to estimate the disability-adjusted life-years (DALYs), and compared these with those given by the Institute for Health Metrics and Evaluation’s Global Burden of Disease (GBD) 2016 study. The PAR increased from 3 to 36% for aflatoxin-related stunting and 14–50% for co-occurrence of stunting and underweight. Using prevalence-based approach, children with aflatoxin related stunting resulted in 48,965.20 (95% uncertainty interval (UI): 45,868.75–52,207.53) DALYs per 100,000 individuals. Children with co-occurrence of stunting and underweight due to exposure to aflatoxin resulted in 40,703.41 (95% UI: 38,041.57–43,517.89) DALYs per 100,000 individuals. Uncertainty analysis revealed that reducing aflatoxin exposure in high exposure areas upto non-detectable levels could save the stunting DALYs up to 50%. The burden of childhood all causes stunting is greater in countries with higher aflatoxin exposure such as Benin. In high exposure areas, these results might help guide research protocols and prioritisation efforts and focus aflatoxin exposure reduction. HEFCE Global Challenge Research Fund Aflatoxin project.
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Nabwire Wangia-Dixon R, Xue KS, Alcala J, Quach THT, Song X, Tang L, Ombaka J, Githanga DP, Anzala OA, Wang JS. Nutrition and growth outcomes are affected by aflatoxin exposures in Kenyan children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2020; 37:2123-2134. [PMID: 33026957 DOI: 10.1080/19440049.2020.1825825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Aflatoxin exposure, malnutrition and growth impairment in children present significant public health problems in low- and middle-income countries. Recent epidemiology studies show that exposure to aflatoxins through dietary sources in early life contributes to growth retardation among children. However, the findings remain inconclusive due to limited comparative studies in high versus low aflatoxin exposure regions. This cross-sectional study presents aflatoxin exposure levels among children aged 6 to 12 years, and further evaluates the association between aflatoxin exposure levels, malnutrition and growth impairment in Kenya, East Africa. AFB1-lysine adducts are validated biomarkers of exposure and were quantified using HPLC with fluorescence detection. All children (n = 746) had detectable levels of AFB1-lysine adducts in serum, range 0.65-518.9 pg/mg albumin with a geometric mean (GM) of 10.5 (95%CI 9.4-11.7) pg/mg albumin. The Geometric Means (GM) of AFB1-lysine adducts were 14.0 (95%CI 12.5, 15.7) pg/mg albumin and 8.2 (95%CI 7.6, 8.8) pg/mg albumin (p-value < 0.001), among children recruited from Makueni and Siaya Counties, respectively. While the study confirms higher human exposure levels in Makueni county, it provides an initial data set for aflatoxin exposure levels among children recruited from Siaya County. In multivariate analysis, after adjusting for socio-economic indicators, farming practices, and household dietary patterns, increasing one unit of log AFB1-lysine was associated with decreasing Weight-for-age z-score (WAZ) by -0.13, p-value = 0.019 among all children aged 6-12 years. Among children 6 to 9 years, WAZ decreases by -0.11 (-0.54, -0.01), p-value = 0.049. Additional growth parameters Height-for-age z-score (HAZ) and Weight-for-height z-score (WHZ) do not reach statistical significance. HAZ decreases by -0.08, p-value = 0.337 and WHZ decreases by -0.17, p-value = 0.437 with every increase in log AFB1-lysine. These data suggest that efforts must be put in place to control for aflatoxin exposure in order to achieve better growth outcomes.
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Affiliation(s)
| | - Kathy Siyu Xue
- Department of Environmental Health Science, University of Georgia , Athens, Georgia, USA
| | - Jessica Alcala
- Department of Environmental Health Science, University of Georgia , Athens, Georgia, USA
| | - Trang Ho Thu Quach
- Department of Epidemiology and Biostatistics, University of Georgia , Athens, Georgia, USA
| | - Xiao Song
- Department of Epidemiology and Biostatistics, University of Georgia , Athens, Georgia, USA
| | - Lili Tang
- Department of Environmental Health Science, University of Georgia , Athens, Georgia, USA
| | - James Ombaka
- School of Public Health and Community Development, Maseno University , Maseno, Kenya
| | - David Peter Githanga
- Peadiatrics, Cardiology and Child Health, Nairobi Hospital , Nairobi, Kenya.,Medical Microbiology Department, University of Nairobi , Nairobi, Kenya
| | - Omu Aggrey Anzala
- Medical Microbiology Department, University of Nairobi , Nairobi, Kenya.,KAVI Institute of Clinical Research, University of Nairobi , Nairobi, Kenya
| | - Jia-Sheng Wang
- Department of Environmental Health Science, University of Georgia , Athens, Georgia, USA
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Schrenk D, Bignami M, Bodin L, Chipman JK, del Mazo J, Grasl‐Kraupp B, Hogstrand C, Hoogenboom L(R, Leblanc J, Nebbia CS, Nielsen E, Ntzani E, Petersen A, Sand S, Schwerdtle T, Vleminckx C, Marko D, Oswald IP, Piersma A, Routledge M, Schlatter J, Baert K, Gergelova P, Wallace H. Risk assessment of aflatoxins in food. EFSA J 2020; 18:e06040. [PMID: 32874256 PMCID: PMC7447885 DOI: 10.2903/j.efsa.2020.6040] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
EFSA was asked to deliver a scientific opinion on the risks to public health related to the presence of aflatoxins in food. The risk assessment was confined to aflatoxin B1 (AFB1), AFB2, AFG1, AFG2 and AFM1. More than 200,000 analytical results on the occurrence of aflatoxins were used in the evaluation. Grains and grain-based products made the largest contribution to the mean chronic dietary exposure to AFB1 in all age classes, while 'liquid milk' and 'fermented milk products' were the main contributors to the AFM1 mean exposure. Aflatoxins are genotoxic and AFB1 can cause hepatocellular carcinomas (HCCs) in humans. The CONTAM Panel selected a benchmark dose lower confidence limit (BMDL) for a benchmark response of 10% of 0.4 μg/kg body weight (bw) per day for the incidence of HCC in male rats following AFB1 exposure to be used in a margin of exposure (MOE) approach. The calculation of a BMDL from the human data was not appropriate; instead, the cancer potencies estimated by the Joint FAO/WHO Expert Committee on Food Additives in 2016 were used. For AFM1, a potency factor of 0.1 relative to AFB1 was used. For AFG1, AFB2 and AFG2, the in vivo data are not sufficient to derive potency factors and equal potency to AFB1 was assumed as in previous assessments. MOE values for AFB1 exposure ranged from 5,000 to 29 and for AFM1 from 100,000 to 508. The calculated MOEs are below 10,000 for AFB1 and also for AFM1 where some surveys, particularly for the younger age groups, have an MOE below 10,000. This raises a health concern. The estimated cancer risks in humans following exposure to AFB1 and AFM1 are in-line with the conclusion drawn from the MOEs. The conclusions also apply to the combined exposure to all five aflatoxins.
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Wangia RN, Githanga DP, Wang JS, Anzala OA. Aflatoxin exposure in children age 6-12 years: a study protocol of a randomized comparative cross-sectional study in Kenya, East Africa. Pilot Feasibility Stud 2019; 5:141. [PMID: 31798942 PMCID: PMC6884745 DOI: 10.1186/s40814-019-0510-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 10/01/2019] [Indexed: 12/30/2022] Open
Abstract
Background Aflatoxins (AFs) are naturally occurring fungal metabolites produced by the Aspergilla species of fungi. The staple food grain, maize (Zea mays), is highly susceptible to AF contamination. In Kenya, contamination of maize supplies by AFs is a recognized public health problem which has resulted in over 600 human deaths. Human exposure to AFs can occur in utero, via breast milk, through weaning foods, and throughout an individual’s lifetime. Recent epidemiological studies have shown that exposure to AFs in early life through diet is a contributing factor to immune suppression, micronutrient deficiency, possible vaccine interference, and impaired growth in children. However, these results remain inconsistent and inconclusive due to lack of randomized controlled studies. Methods A randomized school-based cross-sectional study was designed to study AF exposure levels and associated health effects in children between ages 6 and 12 years. Participants were recruited from primary schools within Siaya and Makueni Counties of Kenya, East Africa. The Joint Ethics Committee of the University of Nairobi and Kenyatta National Hospital in Kenya approved the research protocol and procedures for the study. Both parental consent and child assent were obtained before enrollment in the study. Parents were requested to provide household grain samples and fill out questionnaires detailing their sociodemographic information, household dietary patterns, farming practices, and knowledge of AF contamination. Blood samples were collected from children participants, and sera were prepared for analysis of AFB1-lysine which is one of the validated biomarkers for AF exposure. Discussion This protocol describes a school-based, cross-sectional study whose objective is to comparatively evaluate the role of AF exposure on adverse health outcomes in children. Specifically, effects of cumulative AF exposure on nutritional status, immune markers, and growth parameters will be assessed. Trial registration This study is not a clinical trial, rather a cross-sectional study aimed at providing baseline data on AF exposures in children who live in presumably high versus low AF exposure regions. Results from the study can be used to design interventions and/or prospective cohort studies aimed at studying adverse health effects associated with cumulative AF exposure through diets. The study reference number is P741/12/2017 and registered with KNH-UoN Ethics and Research Committee.
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Affiliation(s)
- Ruth Nabwire Wangia
- 1Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA 30602 USA.,2KAVI Institute of Clinical Research, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
| | - David Peter Githanga
- 3Department of Medical Microbiology, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
| | - Jia-Sheng Wang
- 1Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA 30602 USA
| | - Omu Aggrey Anzala
- 2KAVI Institute of Clinical Research, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.,3Department of Medical Microbiology, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
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Nabwire WR, Ombaka J, Dick CP, Strickland C, Tang L, Xue KS, Wang JS. Aflatoxin in household maize for human consumption in Kenya, East Africa. FOOD ADDITIVES & CONTAMINANTS PART B-SURVEILLANCE 2019; 13:45-51. [PMID: 31775581 DOI: 10.1080/19393210.2019.1690053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The objective of this study is to determine the occurrence and level of aflatoxins (AFs) contamination in freshly harvested maize for human consumption in rural Kenya. Maize kernels and freshly milled maize flour (n = 338) were collected from households in Siaya and Makueni counties. While both counties are representatives of different environmental and climate conditions, Makueni County is the area with reported outbreaks of aflatoxicosis. Samples were analysed for AFB1, AFB2, AFG1, and AFG2 using Ultra High-Pressure Liquid Chromatography with Fluorescence detection. AFs were detected in 100% of the samples with the range of 2.14-411 µg/kg. The geometric mean of total AFs in all samples from Makueni County is 62.5 μg/kg with 95% CI: 53.7, 71.4 while in Siaya County is 52.8 μg/kg with 95% CI: 44.0, 61.7. This study showed that AFs contamination is prevalent in maize-based foods in the region.
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Affiliation(s)
- Wangia Ruth Nabwire
- Department of Environmental Health Science, University of Georgia, Athens, GA, USA
| | - James Ombaka
- School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | | | - Christian Strickland
- Department of Environmental Health Science, University of Georgia, Athens, GA, USA
| | - Lili Tang
- Department of Environmental Health Science, University of Georgia, Athens, GA, USA
| | - Kathy Siyu Xue
- Department of Environmental Health Science, University of Georgia, Athens, GA, USA
| | - Jia-Sheng Wang
- Department of Environmental Health Science, University of Georgia, Athens, GA, USA
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Wangia RN, Tang L, Wang JS. Occupational exposure to aflatoxins and health outcomes: a review. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2019; 37:215-234. [PMID: 31512547 DOI: 10.1080/10590501.2019.1664836] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Aflatoxins [AFs] are secondary metabolites of the fungus species Aspergillus spp. Both animal and epidemiological studies provided sufficient evidence on the carcinogenic, immunotoxic, mutagenic, and genotoxic potential of AFs. While ingestion is the main route of exposure for AFs through consumption of contaminated food products, agricultural workers and personnel who handle AF-contaminated grains are also at higher risk of exposure via inhalation. The main objective of the review is to provide a comprehensive overview of past scientific studies on occupational exposure to AFs, high-risk occupations, and disease outcomes. A search of peer-reviewed articles was done on PubMed and Web of Science Databases. A total of 164 papers was identified and 61 journal articles were selected for further review. High risk occupations include animal husbandry and processing of grain cereals and/or animal feed. Primary liver cancer and respiratory cancers were the most reported as a result of occupational exposure to AFs. For future studies, improved study designs, better characterization of AFs exposure in an occupational setting, and use of biomarkers are recommended in order to promote better understanding of occupational exposure to AFs and the resulting disease burden among workers.
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Affiliation(s)
- Ruth Nabwire Wangia
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Lili Tang
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Jia-Sheng Wang
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
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Etzel RA. Foreword: The effects of exposures to mycotoxins on immunity in children. Curr Probl Pediatr Adolesc Health Care 2019; 49:107-108. [PMID: 31175005 DOI: 10.1016/j.cppeds.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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