Effect of maternal aflatoxin exposure through diet on growth of infants 0 - 3 months in Kisumu County, Kenya

Aflatoxins are naturally occurring carcinogenic toxins associated with poor growth outcomes in young children. Although evidence supports mother-to-infant exposure during pregnancy and breastfeeding, evidence of its effect on growth is limited to the period after introduction of complementary foods. It is, therefore, unclear whether early maternal exposure to aflatoxins affects infant growth right from birth. Prevalence of aflatoxin levels of 40% has been observed in Nyanza region, Kenya, and 22.7% of children under 5 years are stunted. The purpose of this study was to determine the effect of maternal aflatoxin exposure on growth of infants 0-3 months old in Kisumu County, Kenya. Specific objectives were to: establish association between maternal baseline characteristics and aflatoxin exposure; establish association between infant baseline characteristics at birth and maternal aflatoxin exposure; determine effect of maternal aflatoxin exposure on infant growth indicators at 3 months of age. Out of 553 pregnant women who were screened for aflatoxin exposure, 137 exposed and 137 nonexposed women, matched for age and household income, participated in an 8-month cohort study. The women were followed up to delivery and their infants up to 3 months after delivery. Infant length and weight data was collected monthly. Length-for-age (LAZ), weight-for-length (WLZ)) and weight-for-age (WAZ) z-scores were generated. Aflatoxin levels were analyzed using Enzyme Linked Immunosorbent Assay (ELISA) in parts per billion (ppb). Effects of aflatoxin on infant growth outcomes were assessed using multi-variate linear and logistic regression. Effect of maternal aflatoxin exposure on infant length, weight, LAZ, WLZ, WAZ was determined using Cox regression with constant time at risk. Infants of exposed women had lower weight (95% CI:-0.85,-0.53), length (95% CI: -4.08, -3.36), LAZ (95% CI: -1.93, -1.16) and WAZ (95% CI:-1.03, -0.54) at 3 months of age, but there was no difference in WLZ (95% CI:-0.03, 0.74). Risk for stunting was higher in infants of exposed women (RR=4.08; 95% CI:1.35, 12.29). There was no difference in the risk for underweight (RR=6.61; 95% CI:0.80-54.33) and wasting (RR=0.37; 95% CI: 0.40, 3.39, P=0.38).These results underpin the need to reduce aflatoxin exposure in infants and young children who are very vulnerable

Exposure of children 4 to 6 months of age to aflatoxin in Kisumu County, Kenya

Contamination of foods by aflatoxins is a global health problem in both developed and developing countries. Exposure to the toxins is associated with a range of effects on health including stunting in children. Commodities at high risk of aflatoxin contamination include cereals, legumes, milk, fish and meats. Children are more vulnerable to effects of aflatoxin exposure compared to adults. Being genotoxic, levels of aflatoxins in foods should be kept as low as possible, given that there is no known threshold at which they may pose a health risk. This study investigated the potential exposure of young children to aflatoxin contamination in Kisumu County, Kenya. Kisumu County may have the potential for low to high levels of aflatoxin contamination due to prevailing weather conditions as well as reliance on maize, sorghum, cassava and rice as the main staple foods, groundnuts as snack and omena (Rastrienobola argentea) and milk as cheap sources of protein. These foods are also used as weaning foods in the County. Samples of omena, rice, groundnuts, cassava, maize, and sorghum were collected from Kibuye wholesale market, Kibuye open air market, Ahero market, Oile market and Mamboleo market in Kisumu County using a combination of cluster and systematic sampling. Processed cow’s milk samples were collected from supermarkets and raw cow’s milk samples from 3 market milk bazaars in the County. Analysis of solid foods was done using HELICA Total Aflatoxin Assay, intended for quantitative detection of aflatoxin B1, B2, G1 and G2. Milk sampling was done using the European model outlined in the Codex Alimentarius. Aflatoxin M1 levels in milk were analyzed using HELICA Aflatoxin M1 Assay. Aflatoxin levels in the foods ranged from 0 to 34.5 ppb aflatoxin B1, 0.012 to 0.127 ppb aflatoxin M1 in processed milk and 0.0002 to 0.013 ppb aflatoxin M1 in raw milk. All the food products, except cassava, had samples with detectable aflatoxin levels. Daily aflatoxin consumption ranged from 35 ng (4.43/kgBw/day) to as high as 872 ng (110.4 ng/kgBW). These findings indicate that weaning children in Kisumu County are potentially exposed to levels of aflatoxins above the permissible amounts, given that the food stuffs that were analyzed are the commonly used weaning food items. Its effects on their health should be assessed and efforts taken to reduce potential exposure both from the commonly suspected sources as well as from milk.Keywords: Aflatoxin, exposure, infant, weight, heigh

Mycotoxin hazards in the Kenyan food and feed market-a retrospective study

Mycotoxins are toxic fungal metabolites naturally found in food and feed as contaminants. Animal feed and human food samples (n=1818) from three major Kenyan laboratories were categorized as compliant and non-compliant according to Kenya, America (USA) and Europe (EU) mycotoxin regulatory limits. Quantitative risk assessment of dietary aflatoxin intake in maize, wheat, peanut and dairy products in relation to human hepatocellular carcinoma was carried out employing deterministic approach. Non-compliant samples’ proportions were calculated, and logistic regression and chi-square test used to compare different commodities. Animal feed were least compliant, with 64% and 39% having total aflatoxin (AFT) levels above Kenya and USA standards, respectively. Peanuts were the most non-compliant food, with 61% and 47% samples failing Kenya and USA AFT standards respectively, while wheat was least compliant (84%) according to EU threshold for AFT. Half of baby food sampled had AFT level above Kenya and EU standards. High non-compliance rate with Kenya, USA and EU regulatory thresholds with respect to seven different mycotoxins (summarized as “mycotoxins”), and also AFT and aflatoxin M1 alone in edible materials is reported. Significant non-compliance is reported for compound animal feed, peanuts, wheat, baby food, feed ingredients, herbal healthy drink, maize and fodder feed in that order. High levels of aflatoxin residues in animal feed and human food was also observed. Lifetime human consumption of wheat and maize leads to high additional risk for primary liver cancer, human hepatocellular carcinoma (HCC) associated with dietary aflatoxin, wheat and its products causing the highest disease burden. Subsequent implications and limitations of current food safety standards are discussed. Humans and animals in Kenya appear to be chronically exposed to mycotoxin hazards: this calls for surveillance and risk management. There is urgent need for enhanced and consistent surveillance of the dietary mycotoxin hazards observed in this study employing representative sampling plans. Regulation and future research need to focus on reliable analysis techniques, collection of data on toxicological effects of mycotoxins and food consumption pattern, and regulatory limits accordingly set and compliance enforced to protect vulnerable groups such as paediatric, geriatric and sick members of the society to reduce cancer burden in Keny

Mycotoxin hazards in the Kenyan food and feed market - A retrospective study

Mycotoxins are toxic fungal metabolites naturally found in food and feed as contaminants. Animal feed and human food samples (n=1818) from three major Kenyan laboratories were categorized as compliant and non-compliant according to Kenya, America (USA) and Europe (EU) mycotoxin regulatory limits. Quantitative risk assessment of dietary aflatoxin intake in maize, wheat, peanut and dairy products in relation to human hepatocellular carcinoma was carried out employing deterministic approach. Non-compliant samples’ proportions were calculated, and logistic regression and chi-square test used to compare different commodities. Animal feed were least compliant, with 64% and 39% having total aflatoxin (AFT) levels above Kenya and USA standards, respectively. Peanuts were the most non-compliant food, with 61% and 47% samples failing Kenya and USA AFT standards respectively, while wheat was least compliant (84%) according to EU threshold for AFT. Half of baby food sampled had AFT level above Kenya and EU standards. High non-compliance rate with Kenya, USA and EU regulatory thresholds with respect to seven different mycotoxins (summarized as “mycotoxins”), and also AFT and aflatoxin M1 alone in edible materials is reported. Significant non-compliance is reported for compound animal feed, peanuts, wheat, baby food, feed ingredients, herbal healthy drink, maize and fodder feed in that order. High levels of aflatoxin residues in animal feed and human food was also observed. Lifetime human consumption of wheat and maize leads to high additional risk for primary liver cancer, human hepatocellular carcinoma (HCC) associated with dietary aflatoxin, wheat and its products causing the highest disease burden. Subsequent implications and limitations of current food safety standards are discussed. Humans and animals in Kenya appear to be chronically exposed to mycotoxin hazards: this calls for surveillance and risk management. There is urgent need for enhanced and consistent surveillance of the dietary mycotoxin hazards observed in this study employing representative sampling plans. Regulation and future research need to focus on reliable analysis techniques, collection of data on toxicological effects of mycotoxins and food consumption pattern, and regulatory limits accordingly set and compliance enforced to protect vulnerable groups such as paediatric, geriatric and sick members of the society to reduce cancer burden in Kenya

Management of Napier stunting disease

A poster prepared on stunt disease management in Keny

Assessing Crop-Livestock Interaction in Mixed Farming Systems of North Western Kenya

A study was conducted in the four counties the maize- wheat-teapotato and sugarcane-based farming system in North western Kenya to explore the variability among household characteristics and farm productivity. The aim of this work was to establish homogenous groups of crop-livestock mixed farming systems of Kenya. A two step approach was adopted for the study. The first was a rapid rural appraisal followed by a formal survey aimed at establishing farm types to facilitate detailed analysis of synergistic crop-livestock interaction systems. A random sample of 423 farmers was interviewed using a semi structured questionnaire. Descriptive and multinomial techniques were used in the analysis. Two classifications were utilized, the first step was establishing the criteria for classification and the second based on resource accessibility by farmers. The criteria used were the proportions of various crop and livestock enterprises and resource endowment. The process came up with eight farm types based mainly on the farm enterprise orientation, farm size, land productivity, cattle breeding, and farm by-products. Based on the formal survey three farm types were identified as intensive, semi intensive and extensive systems. The resource groups in all the counties were identified by: crop-livestock management, soil fertility management, food security and farm and off-farm income as important indicators of variability. However, all households were net food buyers, implying food insecurity. In addition, off-farm activities and off farm income were important livelihood survival strategies. Development planners and policy makers need to develop unique interventions targeting each specific group, since blanket policies are not appropriate in such a situation. Options such as optimizing livestock numbers to match available feed resources and improving feed availability through breeding and adoption of dual-purpose crop varieties with better digestibility coefficient, improving the cost-effectiveness of existing nutrition technologies (e.g. crop-by-products’), and bringing more land under fodder crops need to be explored. Since the farm sizes within the region had continued to decline, limiting the availability of on-farm livestock feed, there is need for policy instruments that can discourage land fragmentatio

Mycotoxin hazards in the Kenyan food and feed market: A retrospective study

Mycotoxins are toxic fungal metabolites naturally found in food and feed as contaminants. Animal feed and human food samples (n=1818) from three major Kenyan laboratories were categorized as compliant and non-compliant according to Kenya, America (USA) and Europe (EU) mycotoxin regulatory limits. Quantitative risk assessment of dietary aflatoxin intake in maize, wheat, peanut and dairy products in relation to human hepatocellular carcinoma was carried out employing deterministic approach. Non-compliant samples’ proportions were calculated, and logistic regression and chi-square test used to compare different commodities. Animal feed were least compliant, with 64% and 39% having total aflatoxin (AFT) levels above Kenya and USA standards, respectively. Peanuts were the most non-compliant food, with 61% and 47% samples failing Kenya and USA AFT standards respectively, while wheat was least compliant (84%) according to EU threshold for AFT. Half of baby food sampled had AFT level above Kenya and EU standards. High non-compliance rate with Kenya, USA and EU regulatory thresholds with respect to seven different mycotoxins (summarized as “mycotoxins”), and also AFT and aflatoxin M1 alone in edible materials is reported. Significant non-compliance is reported for compound animal feed, peanuts, wheat, baby food, feed ingredients, herbal healthy drink, maize and fodder feed in that order. High levels of aflatoxin residues in animal feed and human food was also observed. Lifetime human consumption of wheat and maize leads to high additional risk for primary liver cancer, human hepatocellular carcinoma (HCC) associated with dietary aflatoxin, wheat and its products causing the highest disease burden. Subsequent implications and limitations of current food safety standards are discussed. Humans and animals in Kenya appear to be chronically exposed to mycotoxin hazards: this calls for surveillance and risk management. There is urgent need for enhanced and consistent surveillance of the dietary mycotoxin hazards observed in this study employing representative sampling plans. Regulation and future research need to focus on reliable analysis techniques, collection of data on toxicological effects of mycotoxins and food consumption pattern, and regulatory limits accordingly set and compliance enforced to protect vulnerable groups such as paediatric, geriatric and sick members of the society to reduce cancer burden in Kenya

Mycotoxin hazards in the Kenyan food and feed market - A retrospective study

Mycotoxins are toxic fungal metabolites naturally found in food and feed as contaminants. Animal feed and human food samples (n=1818) from three major Kenyan laboratories were categorized as compliant and non-compliant according to Kenya, America (USA) and Europe (EU) mycotoxin regulatory limits. Quantitative risk assessment of dietary aflatoxin intake in maize, wheat, peanut and dairy products in relation to human hepatocellular carcinoma was carried out employing deterministic approach. Non-compliant samples’ proportions were calculated, and logistic regression and chi-square test used to compare different commodities. Animal feed were least compliant, with 64% and 39% having total aflatoxin (AFT) levels above Kenya and USA standards, respectively. Peanuts were the most non-compliant food, with 61% and 47% samples failing Kenya and USA AFT standards respectively, while wheat was least compliant (84%) according to EU threshold for AFT. Half of baby food sampled had AFT level above Kenya and EU standards. High non-compliance rate with Kenya, USA and EU regulatory thresholds with respect to seven different mycotoxins (summarized as “mycotoxins”), and also AFT and aflatoxin M1 alone in edible materials is reported. Significant non-compliance is reported for compound animal feed, peanuts, wheat, baby food, feed ingredients, herbal healthy drink, maize and fodder feed in that order. High levels of aflatoxin residues in animal feed and human food was also observed. Lifetime human consumption of wheat and maize leads to high additional risk for primary liver cancer, human hepatocellular carcinoma (HCC) associated with dietary aflatoxin, wheat and its products causing the highest disease burden. Subsequent implications and limitations of current food safety standards are discussed. Humans and animals in Kenya appear to be chronically exposed to mycotoxin hazards: this calls for surveillance and risk management. There is urgent need for enhanced and consistent surveillance of the dietary mycotoxin hazards observed in this study employing representative sampling plans. Regulation and future research need to focus on reliable analysis techniques, collection of data on toxicological effects of mycotoxins and food consumption pattern, and regulatory limits accordingly set and compliance enforced to protect vulnerable groups such as paediatric, geriatric and sick members of the society to reduce cancer burden in Kenya