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A pilot study to evaluate aflatoxin exposure in a rural Ugandan population
Author(s) -
Asiki Gershim,
Seeley Janet,
Srey Chou,
Baisley Kathy,
Lightfoot Tracy,
Archileo Kaaya,
Agol Dorice,
Abaasa Andrew,
Wakeham Katie,
Routledge Michael N.,
Wild Christopher P.,
Newton Robert,
Gong Yun Yun
Publication year - 2014
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12283
Subject(s) - aflatoxin , medicine , population , serostatus , albumin , cohort , biology , environmental health , human immunodeficiency virus (hiv) , microbiology and biotechnology , immunology , viral load
Abstract Objectives The fungal metabolite aflatoxin is a common contaminant of foodstuffs, especially when stored in damp conditions. In humans, high levels can result in acute hepatic necrosis and death, while chronic exposure is carcinogenic. We conducted a pilot study nested within an existing population cohort (the General Population Cohort), to assess exposure to aflatoxin, among people living in rural south‐western Uganda. Methods Sera from 100 adults and 96 children under 3 years of age (85 male, 111 female) were tested for aflatoxin–albumin adduct ( AF ‐alb), using an ELISA assay. Socio‐demographic and dietary data were obtained for all participants; HIV serostatus was available for 90 adults and liver function tests ( LFT s) for 99. Results Every adult and all but four children had detectable AF ‐alb adduct, including five babies reported to be exclusively breastfed. Levels ranged from 0 to 237.7 pg/mg albumin and did not differ significantly between men and women, by age or by HIV serostatus; 25% had levels above 15.1 pg/mg albumin. There was evidence of heterogeneity between villages ( P = 0.003); those closest to trading centres had higher levels. Adults who consumed more Matooke (bananas) had lower levels of AF ‐alb adduct ( P = 0.02) than adults who did not, possibly because their diet contained fewer aflatoxin‐contaminated foods such as posho (made from maize). Children who consumed soya, which is not grown locally, had levels of AF ‐alb adduct that were almost twice as high as those who did not eat soya ( P = 0.04). Conclusions Exposure to aflatoxin is ubiquitous among the rural Ugandans studied, with a significant number of people having relatively high levels. Sources of exposure need to be better understood to instigate practical and sustainable interventions.