Main complementary food ingredients contributing to aflatoxin exposure to infants and young children in Kongwa, Tanzania

Contextual interlinkages and authority levels for strengthening coordination of national food safety control systems in Africa

Africa is the greatest contributor to the burden of foodborne diseases in the world. The problem is associated with the weak food safety control systems in many countries of Africa. Africa's national food control systems are based on fragmented legislation which provide for multiple jurisdictions resulting in weaknesses in coordination, inspection and enforcement of food safety measures mandated to different sectors such as agriculture, trade, and health. It was hypothesized that the weak food safety legislation is a result of inability to contextualize and appreciate the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) guidelines for strengthening national food control systems. Raising awareness and knowledge on interlinkages and authority levels among the sectoral food safety actors can foster appreciation of the FAO and WHO recommendations and inform food safety policy reforms in the continent. This article highlights the interlinkages in food safety activities of the actors along the food chain. It also contextualizes the roles of each agency or ministry and proposes institutional arrangements to be considered in strengthening national food safety control systems in Africa.

Risk of exposure to aflatoxin M1 through consumption of cow's milk among children in Magadu, Morogoro

Aflatoxin M1 (AFM1) contamination of milk affects the general population with particular attention to children who frequently consume milk as part of complementary food. This study determined AFM1 contamination of cow's milk and estimated the health risk of dietary AFM1 through consumption of cow's milk among children (6 to 36 months) in the Magadu ward of Morogoro region in Tanzania. A total of 165 mother-baby pairs were recruited and interviewed on child feeding practices with a focus on feeding of cow's milk in the past 24 h. Alongside the interview, 100 raw cows' milk samples were collected from subsampled respondent households and were analyzed for AFM1 using enzyme-linked immunosorbent assay (ELISA). The results showed that about 35% of the surveyed children consumed cow's milk in the form of plain milk, incorporated in porridge and/or tea. The amount consumed varied from 62.5 to 500 mls with a median of 125 (125, 250) mls at a frequency of 1 to 2 times a day. All raw cows' milk (100%) samples (n = 100) were found contaminated with AFM1 at concentrations ranging from 0.052 to 9.310 µg/L and median of 2.076 µg/L (1.27, 2.48). All samples were contaminated by AFM1 at levels above the limits of 0.05 µg/L of raw milk set by the Tanzania Bureau of Standard and the European Union, while 97% exceeded 0.5 µg/L set by the US Food and Drug Administration. Exposure to AFM1 due to consumption of cow's milk ranged from 0.0024 to 0.077 µg/kg bw per day with a median of 0.019 (0.0016, 0.026) µg/kg bw per day, while the margin of exposure (MOE) ranged from 5.19 to 166.76 and median 20.68 (15.33, 25.40) implying high risk of public health concern. This study recommends that advocacy on consumption of cows' milk to combat undernutrition in children should consider a holistic approach that considers the milk's safety aspect.

Maasai mother's knowledge on complementary feeding practices and nutritional status of children aged 6-24 months in Monduli District, Arusha, Tanzania: A case study of Naitolia village

Despite Tanzania's achievement in reducing childhood problems, undernutrition is still a problem. Little is known about how mothers' knowledge on complementary feeding practice affects their children nutritional status. Therefore, the study determined how nutritional status of Maasai children aged 6-24 months is related to their mothers or caregivers' knowledge on complementary feeding. A semistructured questionnaire was used in analytical cross-sectional study including 286 Maasai mothers and their 6-24-month-old children. A convenient and snowball sampling were employed in choosing households and mothers. Using SPSS version 20 and ENA for SMART software, demographic variables, mother's complementary feeding knowledge and practices, and anthropometric data were examined. Respondents were mostly young female aged 29 ± 9.5 years, married (89.2%), housewives (88.8%), with no formal education (39.1%). Maasai mothers (51.1%) introduced complementary foods at 4 months. Of all children, 75.2% did not attain minimum acceptable diet, whereas 66.1% and 57.3% did not meet minimum number of meals per day and recommended variety of foods, respectively. Based on complementary feeding practices, underweight was associated with timely introduction of complementary foods (p = .000), minimum dietary diversity (p = .001), and minimum acceptable diet (p = .001). Stunting was associated with minimum acceptable diet (p = .0027). Regarding mother's knowledge, underweight was associated with breastfeeding duration (p = .000) and meals adequacy (p = .014). Wasting was associated with breastfeeding duration (p = .027). Maasai mothers' weaning practices were unsatisfactory and children's nutritional status was poor. Children's nutritional status was significantly associated with mother's understanding on complementary feeding, which was only somewhat adequate.

Prevalence of aflatoxin along processing points of locally made complementary food formulae in northern Uganda: Safety and children's exposure across seasons

Aflatoxin contamination along the processing points of locally made complementary food composite needs to be ascertained and minimized to reduce exposure to weaning children. The study established the concentrations of total aflatoxin (TAF) and aflatoxin B1 (AFB1) along the processing points of locally made malted millet sesame soybean composite (MMSSC) across season one (wet) and season two (dry) and determined children's exposure to them. A total of 363 samples were collected in 2019. TAF and AFB1 concentrations were determined quantitatively using an enzyme-linked immunosorbent assay (ELISA). Consequently, exposure of individual children was assessed as Estimated Daily Intake (EDI), (ng kg-1 bw day-1). All the samples along the processing points had detectable concentrations of TAF and AFB1 ranging from 0.578 μg kg-1 to 1.187 μg kg-1 and 0.221 μg kg-1 to 0.649 μg kg-1 respectively. Contamination was highest in raw materials; soybean (Glycine max) > sesame (Sesamum indicum), followed by stored composite, freshly prepared composite, and least in millet (Eleusine coracana). Contamination varied significantly across seasons with the wet season having higher contamination than the dry season at P = 0.05. All samples (100%) were within the European Commission (EC) acceptable maximum tolerable level for TAF and AFB1 (4 μg kg-1 and 2 μg kg-1) respectively for processed foods for general consumption. But were below the EU acceptable maximum tolerable level for TAF and AFB1 (0.4 μg kg-1 and 0.1 μg kg-1) respectively for processed baby foods cereals. However, all were within the United States- Food and Drug Authority (US-FDA) and East African Community (EAC) set maximum acceptable limit of 20 μg kg-1 for TAFs, 10 μg kg-1 and 5 μg kg-1 for TAF and AFB1 respectively. Conversely, exposure to these toxins was much higher than the Provisional Maximum Tolerable Dietary Intake (PMTDI) of 0.4 ng kg-1 bw day-1 to 1.0 ng kg-1 bw day-1. A significant difference in exposure to both toxins was observed with the weight. The age of 5 months was the most exposed. A concerted effort is needed to reduce children's exposure to MMSSC to TAF and AFB1, taking sesame and soybean as priority ingredients and proper storage based on season to control contamination.

Early-life AFB1 exposure: DNA methylation and hormone alterations

Aflatoxins are secondary metabolites of mold that contaminate food and feedstuff. They are found in various food including grains, nuts, milk and eggs. Aflatoxin B1 (AFB1) is the most poisonous and commonly found of the various types of aflatoxins. Exposures to AFB1 start early in life viz. in utero, during breastfeeding, and during weaning through the waning foods which are mainly grain based. Several studies have shown that early-life exposures to various contaminants may have various biological effects. In this chapter, we reviewed the effects of early-life AFB1 exposures on changes in hormone and DNA methylation. In utero AFB1 exposure results in alterations in steroid and growth hormones. Specifically, the exposure results in a reduction in testosterone levels later in life. The exposure also affects the methylation of various genes that are significant in growth, immune, inflammation, and signaling pathways.