.2018 Jun:115:29-37.

doi: 10.1016/j.envint.2018.03.001. Epub 2018 Mar 13.

Exposure to aflatoxin and fumonisin in children at risk for growth impairment in rural Tanzania

Chen Chen¹, Nicole J Mitchell², Jean Gratz³, Eric R Houpt³, Yunyun Gong⁴, Patricia A Egner⁵, John D Groopman⁵, Ronald T Riley⁶, Jency L Showker⁶, Erling Svensen⁷, Estomih R Mduma⁸, Crystal L Patil⁹, Felicia Wu¹⁰

Affiliations

¹ Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
² Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA; Uckele Health and Nutrition, Blissfield, MI, USA.
³ Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
⁴ School of Food Science and Nutrition, University of Leeds, UK.
⁵ Department of Environmental Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA.
⁶ Toxicology and Mycotoxin Research Unit, National Poultry Disease Research Center, R.B. Russell Research Center, USDA-ARS, Athens, GA, USA.
⁷ Haukeland University Hospital, Bergen, Norway; Haydom Lutheran Hospital, Manyara Region, Tanzania; University of Bergen, Norway.
⁸ Haydom Lutheran Hospital, Manyara Region, Tanzania.
⁹ Department of Women, Children and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, IL, USA.
¹⁰ Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA. Electronic address: fwu@msu.edu.

PMID:29544138
PMCID: PMC5989662
DOI: 10.1016/j.envint.2018.03.001

Exposure to aflatoxin and fumonisin in children at risk for growth impairment in rural Tanzania

Chen Chen et al. Environ Int.2018 Jun.

.2018 Jun:115:29-37.

doi: 10.1016/j.envint.2018.03.001. Epub 2018 Mar 13.

Authors

Affiliations

¹ Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
² Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA; Uckele Health and Nutrition, Blissfield, MI, USA.
³ Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
⁴ School of Food Science and Nutrition, University of Leeds, UK.
⁵ Department of Environmental Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA.
⁶ Toxicology and Mycotoxin Research Unit, National Poultry Disease Research Center, R.B. Russell Research Center, USDA-ARS, Athens, GA, USA.
⁷ Haukeland University Hospital, Bergen, Norway; Haydom Lutheran Hospital, Manyara Region, Tanzania; University of Bergen, Norway.
⁸ Haydom Lutheran Hospital, Manyara Region, Tanzania.
⁹ Department of Women, Children and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, IL, USA.
¹⁰ Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA. Electronic address: fwu@msu.edu.

PMID:29544138
PMCID: PMC5989662
DOI: 10.1016/j.envint.2018.03.001

Abstract

Growth impairment is a major public health issue for children in Tanzania. The question remains as to whether dietary mycotoxins play a role in compromising children's growth. We examined children's exposures to dietary aflatoxin and fumonisin and potential impacts on growth in 114 children under 36 months of age in Haydom, Tanzania. Plasma samples collected from the children at 24 months of age (N = 60) were analyzed for aflatoxin B₁-lysine (AFB₁-lys) adducts, and urine samples collected between 24 and 36 months of age (N = 94) were analyzed for urinary fumonisin B₁ (UFB₁). Anthropometric, socioeconomic, and nutritional parameters were measured and growth parameter z-scores were calculated for each child. Seventy-two percent of the children had detectable levels of AFB₁-lys, with a mean level of 5.1 (95% CI: 3.5, 6.6) pg/mg albumin; and 80% had detectable levels of UFB₁, with a mean of 1.3 (95% CI: 0.8, 1.8) ng/ml. This cohort had a 75% stunting rate [height-for-age z-scores (HAZ) < -2] for children at 36 months. No associations were found between aflatoxin exposures and growth impairment as measured by stunting, underweight [weight-for-age z-scores (WAZ) < -2], or wasting [weight-for-height z-scores (WHZ) < -2]. However, fumonisin exposure was negatively associated with underweight (with non-detectable samples included, p = 0.0285; non-detectable samples excluded, p = 0.005) in this cohort of children. Relatively low aflatoxin exposure at 24 months was not linked with growth impairment, while fumonisin exposure at 24-36 months based on the UFB₁ biomarkers may contribute to the high growth impairment rate among children of Haydom, Tanzania; which may be associated with their breast feeding and weaning practices.

Keywords: Aflatoxin; Biomarkers; Child growth; Dietary exposure; Fumonisin.

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Figures

**Fig. 1**
Linear regressions of WAMI index (n = 94) with HAZ (a), WAZ (b) and WHZ (c) values.

**Fig. 2**
Linear regressions of WAZ and UFB₁ concentrations, with non-detects included (a;p-value = 0.0285, n = 94) and non-detects excluded (b;p-value = 0.0053, n = 75), respectively.

**Fig. 3**
Associations of UFB₁ concentrations (divided by quartiles, n = 23 or 24) with anthropometric z-scores (HAZ, WAZ and WHZ values). The box plots show median (solid line), the 25th and 75th percentile (upper and lower limits of the box) and 10th and the 90th percentile (error bars) for HAZ, WAZ and WHZ values. An asterisk indicates significant difference between the 3rd and the 4th quartile (p < 0.05).

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Exposure to aflatoxin and fumonisin in children at risk for growth impairment in rural Tanzania

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Exposure to aflatoxin and fumonisin in children at risk for growth impairment in rural Tanzania

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