Co-occurrence of fumonisins with aflatoxins in home-stored maize for human consumption in rural villages of Tanzania

Pre- and post-harvest aflatoxin contamination and management strategies of Aspergillus spoilage in East African Community maize: review of etiology and climatic susceptibility

Globally, maize (Zea mays L.) is deemed an important cereal that serves as a staple food and feed for humans and animals, respectively. Across the East African Community, maize is the staple food responsible for providing over one-third of calories in diets. Ideally, stored maize functions as man-made grain ecosystems, with nutritive quality changes influenced predominantly by chemical, biological, and physical factors. Food spoilage and fungal contamination are convergent reasons that contribute to the exacerbation of mycotoxins prevalence, particularly when storage conditions have deteriorated. In Kenya, aflatoxins are known to be endemic with the 2004 acute aflatoxicosis outbreak being described as one of the most ravaging epidemics in the history of human mycotoxin poisoning. In Tanzania, the worst aflatoxin outbreak occurred in 2016 with case fatalities reaching 50%. Similar cases of aflatoxicoses have also been reported in Uganda, scenarios that depict the severity of mycotoxin contamination across this region. Rwanda, Burundi, and South Sudan seemingly have minimal occurrences and fatalities of aflatoxicoses and aflatoxin contamination. Low diet diversity tends to aggravate human exposure to aflatoxins since maize, as a dietetic staple, is highly aflatoxin-prone. In light of this, it becomes imperative to formulate and develop workable control frameworks that can be embraced in minimizing aflatoxin contamination throughout the food chain. This review evaluates the scope and magnitude of aflatoxin contamination in post-harvest maize and climate susceptibility within an East African Community context. The paper also treats the potential green control strategies against Aspergillus spoilage including biocontrol-prophylactic handling for better and durable maize production.

Aflatoxins and fumonisins in conventional and organic corn: a comprehensive review

This review analyzes the occurrence and co-exposure of aflatoxins and fumonisins in conventional and organic corn, and compares the vulnerability to contamination of both. The risks of fungal contamination in corn are real, mainly by the genera Aspergillus and Fusarium, producers of aflatoxins and fumonisins, respectively. Aflatoxins, especially AFB1, are related to a high incidence of liver cancer, and the International Agency Research of Cancer (IARC) classified them in group 1A 'carcinogenic to humans'. The occurrence in conventional corn is reported in many countries, including at higher levels than those established by legislation. IARC classified fumonisins in group 2B 'possibly carcinogenic to humans' due to their link with incidence of esophageal cancer. However, comparing corn and organic and conventional by-products from different regions, different results are observed. The co-occurrence of both mycotoxins is a worldwide problem; nevertheless, there is little data on the comparison of the co-exposure of these mycotoxins in corn and derivatives between both systems. It was found that the agricultural system is not a decisive factor in the final contamination, indicating the necessity of effective strategies to reduce contamination and co-exposure at levels that do not pose health risks.

Aspergillus flavus and Fusarium verticillioides and Their Main Mycotoxins: Global Distribution and Scenarios of Interactions in Maize

Maize is frequently contaminated with multiple mycotoxins, especially those produced by Aspergillus flavus and Fusarium verticillioides. As mycotoxin contamination is a critical factor that destabilizes global food safety, the current review provides an updated overview of the (co-)occurrence of A. flavus and F. verticillioides and (co-)contamination of aflatoxin B1 (AFB1) and fumonisin B1 (FB1) in maize. Furthermore, it summarizes their interactions in maize. The gathered data predict the (co-)occurrence and virulence of A. flavus and F. verticillioides would increase worldwide, especially in European cold climate countries. Studies on the interaction of both fungi regarding their growth mainly showed antagonistic interactions in vitro or in planta conditions. However, the (co-)contamination of AFB1 and FB1 has risen worldwide in the last decade. Primarily, this co-contamination increased by 32% in Europe (2010-2020 vs. 1992-2009). This implies that fungi and mycotoxins would severely threaten European-grown maize.

Presence, Co-Occurrence, and Daily Intake Estimates of Aflatoxins and Fumonisins in Maize Consumed in Food-Insecure Regions of Western Honduras

Foodborne mycotoxins are a significant food safety risk in developing countries. Our objective was to determine the occurrence of and exposure levels to aflatoxins (AFs) and fumonisins (FBs) in maize intended for human and animal consumption in food-insecure regions of western Honduras. Total AFs and FBs were quantified with a monoclonal antibody-based affinity spectrofluorimetric method. FBs were detected in 614/631 samples of maize destined for human consumption at 0.3 to 41 mg/kg (mean, 2.7 mg/kg). Of the 614 positive samples, 147 had FB levels exceeding the U.S. Food and Drug Administration (FDA) advisory threshold of 4.0 mg/kg. AFs were detected in 109/631 samples of maize for human consumption with concentrations between 1.0 and 490 µg/kg (mean, 10 µg/kg). AF levels in 34 samples exceeded the FDA regulatory limit (i.e., 20 µg/kg). The average probable daily intake of AFs in western Honduras ranged from 0 to 260 ng/kg body weight/day, and for FBs, the average probable daily intake ranged from 17 to 53 μg/kg body weight/day. AFs and FBs co-occurred in 106/631 samples with 60 samples containing both toxins at levels greater than the FDA regulatory levels. Samples of maize intended for animal feed had significantly higher AF (mean, 22 µg/kg) and FB (mean, 7.6 mg/kg) contamination levels than those observed in samples destined for human consumption. Thus, the maize supply chain in western Honduras is contaminated with mycotoxins at levels that pose health risks to both humans and livestock. More effective mycotoxin surveillance and implementation of effective mitigation strategies are needed to reduce mycotoxin contamination and exposure.

Fusarium verticillioides of maize plant: Potentials of propitious phytomicrobiome as biocontrol agents

Disease outbreaks have been recorded due to exposure to Fusarium verticillioides and fumonisin, a mycotoxin produced by this fungus. F. verticillioides is a fungal pathogen of maize that causes infections, such as wilting and rotting, while contact with its fumonisin derivative manifests in the form of mild to severe illnesses in humans and animals. Maize infection by F. verticillioides causes loss or reduction in expected crop yield, thereby influencing households and nations' economies. While several efforts have been made to control the pathogenic fungus and its occurrence in the environment, it remains a challenge in agriculture, particularly in maize production. Several microorganisms which are plant-associated, especially those associated with the rhizosphere niche have been noted to possess antagonistic effects against F. verticillioides. They can inhibit the pathogen and tackle its debilitating effects on plants. Hence this study reviews the use of rhizosphere-associated biocontrol agents, such as Bacillus spp., Pseudomonas, Enterobacter, and Microbacterium oleivorans which forms part of the phytomicrobiome in other to prevent and control this toxicogenic fungus. These microorganisms were found to not only be effective in controlling its occurrence on maize plants but are environmentally safe and promote crop yield.

Harvest and post-harvest handling practices associated with fumonisin B1 contamination in maize (Zea mays L.): dietary exposure and risk characterization in eastern Ethiopia

Maize is the main staple food crop in the eastern part of Ethiopia. However, maize loss is a major issue due to fungal contamination especially at the post-harvest stage owing to inadequate handling practices. This study aimed to assess post-harvest handling and awareness against fungal development and fumonisin B₁ (FB₁) in maize and to calculate risk exposures of FB₁. A total of 197 maize samples (grain and flour) were collected from five districts (Haramaya, Kersa, Meta, Oda Bultum, and Tullo). FB₁ was detected using LC-MS/MS qTRAP. Exposure assessment was done based on the maize consumption rate per day in Ethiopia for different age groups (infants, children, and adults). Risk characterization depends on the margin of exposure (MoE) combined with the lower confidence limit of the benchmark dose level (BMDL). About 81% of farmers were not physically separating undamaged maize ears with damaged from either birds or fungi. Moreover, 100% were not using improved storage material. In storage samples, FB₁ was detected as high as 1058 μg/kg ± 234 in the Kersa district while a minimum of 22.60 μg/kg ± 5.27 in Meta. In flour samples, the maximum FB₁ (327 μg/kg) was detected from the Oda Bultum district. The maximum exposure of infants was estimated at Kersa (1131 µg/kg bw/day), followed by Oda Bultum (1073 µg/kg bw/day) and Haramaya (854 µg/kg bw/day). Overall, FB₁ exposures ranged from 6.09 to 1131 µg/kg bw/day, which is 3 to 500 µg/kg bw/day higher than the maximum tolerable daily intake of 2 µg/kg bw/day recommended by the World Health Organization. The MoE ranged from 0.15 to 176, with infants being at higher risk than adults. The study highlights the urgent need to enhance growers' awareness and knowledge of good post-harvest practices to reduce mycotoxin contamination in maize. Further biomarker analysis must be pursued to determine the risk exposure assessment for different age groups in these areas with a priority for the Kersa district.

Atoxigenic-based technology for biocontrol of aflatoxin in maize and groundnuts for Tanzania

Application of biocontrol products containing atoxigenic isolates of Aspergillus flavus to reduce aflatoxin content in crops is an effective strategy for managing aflatoxin in several regions throughout the world. We report the development and validation of two aflatoxin biocontrol products, Aflasafe TZ01 and Aflasafe TZ02, for use in maize and groundnut in Tanzania, a country frequently affected by aflatoxin contamination. Each product contains four atoxigenic A. flavus genotypes native and widely distributed in Tanzania. Efficacy tests on maize and groundnut were conducted over two years and in four regions of Tanzania where aflatoxin contamination is prevalent. Application of both products significantly (P<0.05) reduced aflatoxin levels in maize and groundnut in both years and in all districts. No differences were observed in total Aspergillus section Flavi population in treated and untreated fields, revealing that application of the biocontrol products do not alter overall Aspergillus populations in the environment. The results indicate that both products are effective tools for aflatoxin mitigation in groundnut and maize. The products were officially registered in 2018. Currently, there are scale-out and-up efforts of aflatoxin biocontrol products in Tanzania through a private sector company that is making the products available to farmers. Protecting maize and groundnut from aflatoxin contamination in Tanzania can result in health, income, and trade benefits.

Fumonisins in African Countries

Maize and other cereals are the commodities most contaminated with fumonisins. The maize acreage is increasing in Africa, and the maize harvest provides important foods for humans and feeds for domestic animals throughout the continent. In North Africa, high levels of fumonisins have been reported from Algeria and Morocco, while low levels have been detected in the rather few fumonisin analyses reported from Tunisia and Egypt. The West African countries Burkina Faso, Cameroon, Ghana, and Nigeria all report high levels of fumonisin contamination of maize, while the few maize samples analysed in Togo contain low levels. In Eastern Africa, high levels of fumonisin contamination have been reported from the Democratic Republic of Congo, Ethiopia, Kenya, Tanzania, and Uganda. The samples analysed from Rwanda contained low levels of fumonisins. Analysis of maize from the Southern African countries Malawi, Namibia, South Africa, Zambia, and Zimbabwe revealed high fumonisin levels, while low levels of fumonisins were detected in the few analyses of maize from Botswana and Mozambique.

Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes: a prospective cohort study in rural Ethiopia

INTRODUCTION

Mycotoxin exposure during pregnancy has been associated with adverse birth outcomes in low- and middle-income countries. The evidence, however, is inconsistent and mainly limited to the assessment of a single mycotoxin. We assessed biomarkers of exposure to multiple mycotoxins during pregnancy and their associations with adverse birth outcomes in rural Ethiopia.

METHODS

We analyzed data from 579 pregnant women between 8 and 24 weeks of completed gestation enrolled in a prospective cohort study. Serum mycotoxin concentrations were determined using liquid chromatography coupled with tandem mass spectrometry. Multivariable linear probability models, adjusted for potential confounding factors and multiple comparisons, were fitted to assess the associations between mycotoxin exposure and small for gestational age and preterm birth. We applied principal component analysis to reduce the dimensionality of biomarker data from several taxonomic mycotoxin groups.

RESULTS

All pregnant women were co-exposed to at least five mycotoxins, and one pregnant woman was co-exposed to 27 mycotoxins. Fumonisins (FB), i.e., FB₂, FB₃, FB₁, and tenuazonic acid were the most frequently identified mycotoxins in 98.8, 95.3, 93.3, and 81.4% of the samples respectively. Deoxynivalenol was detected in 38.7%, nivalenol in 50.1%, ochratoxin α in 67.9%, and zearalenone in 50.9% of the serum samples. After adjustment, we found no statistically significant (all P ≥ 0.05) associations between mycotoxin exposures and birth outcomes.

CONCLUSIONS

Despite our study providing no evidence for relationships between mycotoxin biomarkers and adverse birth outcomes, our findings do indicate an extensive presence of multiple mycotoxin exposure among pregnant women. Public health policies and nutrition-sensitive interventions must ensure exposure to mycotoxins is reduced in rural Ethiopia.

Incidence of aflatoxins and fumonisins in grain, masa and corn tortillas in four municipalities in the department of Lempira, Honduras

In Honduras, corn is the most important staple food for the majority of the population. This high-demand crop is susceptible to biological contamination with mycotoxins, which could represent a latent hazard for consumers. To assess the incidence of aflatoxins and fumonisins in grain, masa and tortilla, and the dietary exposure to these substances among consumers, a study was conducted in four municipalities in the department of Lempira. Total aflatoxin and fumonisin content were quantified by fluorometry in 144 samples from 48 farmers. Sixty five percent of the samples were contaminated with aflatoxins with levels of 1.28-32.05, 1.15 to 12.61, and 1.01-5.98 μg/kg in grain, masa and tortilla, respectively. Fumonisins were detected in 100% of the samples at levels between 0.82 and 28.04, 0.66 and 14.36, and 0.63 and 12.04 mg/kg in grain, masa and tortilla, respectively. The reduction in aflatoxin and fumonisin contamination after processing grains into tortillas was of 83% and 52%, respectively. The difference in aflatoxin and fumonisin concentration in the three products was significant (p < 0.05). With a per capita tortilla consumption of 490 g/day, dietary exposure was estimated between 0.003 and 0.073 μg/kg bw/day for aflatoxins and 6.16 and 151.98 μg/kg bw/day for fumonisins. Therefore, the risk of exposure to mycotoxins in the evaluated communities was considered high. Mixed effect models showed that postharvest grain management and the nixtamalization process affect the incidence of mycotoxins in corn-based products.

Aflatoxin contamination in Tanzania: quantifying the problem in maize and groundnuts from rural households

Aflatoxins are toxic and carcinogenic secondary metabolites, produced by Aspergillus flavus and Aspergillus parasiticus, which contaminate food and feed and threaten human and animal health. To assess the prevalence of aflatoxins in Tanzania, 180 groundnut and 200 maize samples were collected from 9 and 10 districts, respectively. Aflatoxin contamination was quantified using high performance liquid chromatography. Aflatoxins were detected in samples collected from all districts and prevalence ranged from 92 to 100% for groundnuts and 10 to 80% for maize. The mean aflatoxin level for groundnuts was 6.37 μg/kg and the highly contaminated sample had 40.31 μg/kg. For maize, the mean aflatoxin level was 12.47 μg/kg and the highly contaminated sample had 162.40 μg/kg. The estimated average probable daily intake (APDI) of aflatoxin B1 (AFB1) from groundnuts consumption was 1.88 ng/kg body weight/day, while for maize, it ranged between 151.98-272.89 ng/kg body weight/day. The APDI for both groundnut and maize exceeded the provisional maximum tolerable daily intake (PMTDI) of AFB1 for adults (1 ng/kg body weight/day), bringing about health concerns for populations in Tanzania. Another alarming finding was that 75% of the farmers who provided samples for analysis were not aware of aflatoxins or the negative health impacts from consuming contaminated products. Results reported in this paper show that aflatoxin contaminated staple crops are widely distributed in Tanzania and that the risk of human exposure is high due to diet preferences. Awareness campaigns are required to inform and protect farmers and consumers.

Validation and Application of a Low-Cost Sorting Device for Fumonisin Reduction in Maize

Fumonisin mycotoxins are a persistent challenge to human and livestock health in tropical and sub-tropical maize cropping systems, and more efficient methods are needed to reduce their presence in food systems. We constructed a novel, low-cost device for sorting grain, the “DropSort”, and tested its effectiveness on both plastic kernel models and fumonisin-contaminated maize. Sorting plastic kernels of known size and shape enabled us to optimize the sorting performance of the DropSort. The device sorted maize into three distinct fractions as measured by bulk density and 100-kernel weight. The level of fumonisin was lower in the heaviest fractions of maize compared to the unsorted samples. Based on correlations among fumonisin and bulk characteristics of each fraction, we found that light fraction 100-kernel weight could be an inexpensive proxy for unsorted fumonisin concentration. Single kernel analysis revealed significant relationships among kernel fumonisin content and physical characteristics that could prove useful for future sorting efforts. The availability of a low-cost device (materials~USD 300) that can be used to reduce fumonisin in maize could improve food safety in resource-limited contexts in which fumonisin contamination remains a pressing challenge.

Complementary feeding in Kongwa, Tanzania: Findings to inform a mycotoxin mitigation trial

Complementary feeding of 6‐ to 24‐month‐old infants and young children with adequate, safe and developmentally appropriate food is essential to child health. Inappropriate complementary foods and feeding practices are linked to the high incidences of undernutrition among infant and young children in most developing countries, including Tanzania. Mycotoxin risk is an additional concern, given the documented presence of aflatoxin and fumonisin in food systems of Africa, especially maize and groundnut. In preparation for a trial of mycotoxin mitigation, we conducted focus group discussions and recipe trials to explore complementary foods and feeding practices in Kongwa, a rural district of central Tanzania. Sixty mothers of infants from 6 to 18 months of age in five villages across the district were purposefully sampled. During focus group discussions, mothers reported to mostly feed their children with cereal and groundnut‐based foods as thin or thick porridges. The most common porridge preparations contained cereal (mostly, maize) ranging from 66.7% to 80.0% by weight and groundnuts from 7.7% to 33.3%. The ratio of cereal to groundnut ranged from 3:1 to 4:1. For the recipe trial sessions, mothers chose similar ingredients reported during discussions to prepare complementary foods. The reliance on maize and groundnuts in complementary foods predisposes the children to undernutrition and exposure to aflatoxins and fumonisins. These formative research results suggest multiple intervention points to improve complementary feeding and reduce mycotoxin exposure in this population, including education messages package on feeding practices, mycotoxin control practices and complementary food formulation.

Mycotoxins contamination of market maize and the potential of density sorting in reducing exposure in unregulated food systems in Kenya

Aflatoxins and fumonisins commonly contaminate key food staples in tropical countries, causing recurring acute and chronic public health problems. The present study was conducted to assess the potential of a simple device designed for density-based sorting of maize for its potential to reduce aflatoxins and fumonisins in diverse samples of naturally contaminated maize. A cross sectional survey was conducted, analysing market maize samples (n=204) from eight counties in Western Kenya. A quarter (25%) of the maize samples were contaminated with aflatoxin B1 above the legal limit of 5 μg/kg and nearly half (48%) were contaminated with fumonisins at levels above the legal limit of 2 μg/g. Analysis of additional samples (n=24) from Meru County showed that contamination of maize with the two toxins was also common in Eastern Kenya. A simple density sorter was used to separate grain samples into heavy and light fractions. With an out-sort rate of 31%, density sorting was effective in separating maize by bulk density and 100-kernel weight (P<0.001). Bulk density was negatively correlated with aflatoxins in unsorted (r=-0.20, P<0.01) and heavy fractions (r=-0.32, P<0.01). Density sorting was effective at reducing fumonisins; for maize samples with >1 μg/g, the heavy (accepted) fraction had 66% lower fumonisins than the unsorted maize. After density sorting, the light and heavy fractions fumonisin levels differed by an average of 8.38 μg/g (P<0.001). However, sorting was not effective at significantly reducing aflatoxin levels in maize that was highly contaminated. A simple density sorting equipment that could be adopted by local small-scale millers has potential to reduce fumonisins in maize. Additional and complementary sorting technologies, such as size screening and spectral sorting might improve the effectiveness of reducing aflatoxins in maize.

Risks of aflatoxin exposure among adolescents in boarding schools in Kilimanjaro region, Tanzania

School feeding in low-income countries is dominated by cereals and legumes, which are susceptible to aflatoxin contamination but are usually not assessed for aflatoxins. A cross sectional study was conducted to assess aflatoxin exposure among adolescents through consumption of school meals in Kilimanjaro region. Food frequency questionnaires and 24 h dietary recalls were used to collect information on food consumption. At least four samples of common food used in school meals were collected. A deterministic approach was used to estimate the dietary aflatoxin exposure. High Performance Liquid chromatography (HPLC) was used to analyse presence of aflatoxin contamination. Results showed that, maize based food and beans were consumed on daily basis. The intake of maize flour and dehulled maize ranged from 17.5 to 738.2 g and 28.2 to 272 g per person per day respectively. Furthermore, consumption of beans and rice were in the range of 121.1 to 595.2 g and 15.7 to 42.2 g per person per day respectively. Total aflatoxins ranged 0.20-438.53 μg/kg (median 2.30 μg/kg). The highest contamination range (0.59-438.53 μg/kg) was in maize while the lowest (0.20-3.41 μg/kg) was found in rice. Similarly, the highest aflatoxin B1 (AFB1) concentration (35.88 μg/kg) was in dehulled maize while the lowest (0.44 μg/kg) was in rice. The highest dietary exposure to total aflatoxins and AFB1 due to consumption of maize ranged from 0.70 to 973.45 ng/kg/bodyweight (bw)/day, and from 0.05-81.06 ng/kg/bw/day, respectively. This pronounced risk of exposure to aflatoxins might have been contributed by a monotonous maize based diet in boarding schools. These findings call for institutions immediate interventions, such as the use of appropriate storage technologies, sorting, cleaning and winnowing in order to remove damaged grains, thereby reducing the risk of dietary exposure to aflatoxins. Likewise, the relevant ministries should consider food diversification and routine risk assessments of the susceptible crops throughout the value chain as a long-term intervention plan at policy level.

Estimating the risk of aflatoxin-induced liver cancer in Tanzania based on biomarker data

Evidence about the magnitude of the aflatoxin menace can help policy makers appreciate the importance of the problem and strengthen policies to support aflatoxin mitigation measures. In this study, we estimated aflatoxin-induced liver cancer risk in 2016 for Tanzania and used the information to estimate the health burden due to the aflatoxin exposure in the country. The burden of aflatoxin-induced liver cancer was assessed based on available aflatoxin biomarker data from a previous epidemiology study, hepatitis B virus infection prevalence and population size of Tanzania in 2016. The health burden due to aflatoxin-induced liver cancer was estimated using disability adjusted life years (DALYs). The aflatoxin exposures ranged from 15.0-10,926.0 ng/kg bw/day (median, 105.5 ng/kg bw/day). We estimated that in 2016 there were about 1,480 (2.95 per 100,000 persons) new cases of aflatoxin-induced liver cancer in Tanzania and assumed all of them would die within a year. These morbidity and mortality rates led to a total loss of about 56,247.63 DALYs. These results show, quantitatively, the cases of liver cancer and related deaths that could be avoided, and the healthy life years that could be saved, annually, by strengthening measures to control aflatoxin contamination in Tanzania.

The occurrence of aflatoxins and human health risk estimations in randomly obtained maize from some markets in Ghana

Maize and its products are most often prone to fungal contamination especially during cultivation and storage by toxigenic fungi. Aflatoxicosis still persist in Ghana despite the numerous education on several ways of its prevention at the farm as well as its adverse health implications which are food safety concerns. A random assessment and human risk analysis was conducted on 90 maize (72 white and 18 colored) samples from markets across all the regions of Ghana. Total aflatoxins (AFtotal) and the constitutive aflatoxins (AFB₁, AFB₂, AFG₁, and AFG₂) were analyzed by High-Performance Liquid Chromatography (HPLC). Out of a total of ninety (90) samples investigated, 72 (80%) tested positive for AFB₁ and the contamination levels ranged from 0.78 ± 0.04 to 339.3 ± 8.6 µg kg⁻¹. Similarly, AFG2 was detected in only 14 (15.5%) samples, and their values ranged between 1.09 ± 0.03 and 5.51 ± 0.26 µg kg⁻¹ while AF total ranged between 0.78 ± 0.04 and 445.01 ± 8.9 µg kg⁻¹ constituting approximately 72 (80%). Limits of AFB₁ and total aflatoxins (AFtotal) for the Ghana Standards Authority (GSA) (5 and 10 µg kg⁻¹) and the European Food Safety Authority (EFSA) (2 and 4 µg kg⁻¹), were used as checks. A total of 33 (41.25%) samples were above the limits for both. Risk assessments recorded for Estimated Daily Intake (EDI), Hazard Quotient (H.Q), Hazard Index (H.I), Margin of Exposure (MOE), av. Potency, and population risks ranged 0.087–0.38 μg kg⁻¹ bw day⁻¹, 1.5–6.9, 0.0087–0.38, 3.64–12.09, 0–0.0396 ng Aflatoxins kg⁻¹ bw day⁻¹ and, 3.5 × 10^–1–0.015 respectively for total aflatoxins. While ranges for aflatoxins B1 (AFB1) recorded were 0.068–0.3 μg Kg bw⁻¹ day⁻¹, 2.43–10.64, 0.0068–0.030, 4.73–20.51, 0–0.0396 ng Aflatoxins kg⁻¹ bw day⁻¹ and, 2.69 × 10^–3–0.012 for Estimated Daily Intake (EDI), Hazard Quotient (H.Q), Hazard Index (H.I), Margin of Exposure (MOE), Av. potency, and population risks respectively. It was deduced that although there was some observed contamination of maize across the different ecological zones, the consumption of maize (white and colored) posed no adverse health effects on the population of Ghana since computed H.I was less than 1 (< 1).

Exposure to aflatoxins and fumonisins and linear growth of children in rural Ethiopia: a longitudinal study

Objective:

We hypothesise that exposure to aflatoxins and fumonisins, measured in serum, alters protein synthesis, reducing serum protein and insulin-like growth factor 1 (IGF-1), increasing inflammation and infection, leading to child’s linear growth failure.

Design:

Children 6–35 months, stratified by baseline stunting, were subsampled from an intervention trial on quality protein maize consumption and evaluated at two time-points.

Setting:

Blood samples and anthropometric data were collected in the pre-harvest (August–September 2015) and post-harvest (February 2016) seasons in rural Ethiopia.

Participants:

102 children (50 stunted and 52 non-stunted).

Results:

Proportions of children exposed to aflatoxin G1, aflatoxin G2 and aflatoxin M1 were higher in the pre-harvest (8, 33 and 7, respectively) compared to post-harvest season (4, 28 and 4, respectively). The proportion of children exposed to any aflatoxin was higher in the pre-harvest than post-harvest season (51 % v. 41 %). Fumonisin exposure ranged from 0 % to 11 %. In joint statistical tests, aflatoxin exposure was associated with serum biomarkers of inflammation (C-reactive protein, α-1-glycoprotein) and protein status (transthyretin, lysine, tryptophan), IGF-1 and linear growth (all P < 0·01). However, exposure to specific aflatoxins was not significantly associated with any biomarkers or outcomes (all P > 0·05).

Conclusions:

Aflatoxin exposure among rural Ethiopian children was high, with large variation between seasons and individual aflatoxins. Fumonisin exposure was low. There was no clear association between aflatoxin exposure and protein status, inflammation or linear growth. A larger study may be needed to examine the potential biological interactions, and the assessment of aflatoxins in food is needed to determine sources of high exposure.

The Influence of Weather on the Occurrence of Aflatoxin B1 in Harvested Maize from Kenya and Tanzania

A study was conducted using maize samples collected from different agroecological zones of Kenya (n = 471) and Tanzania (n = 100) during the 2013 maize harvest season to estimate a relationship between aflatoxin B1 concentration and occurrence with weather conditions during the growing season. The toxins were analysed by the ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method. Aflatoxin B1 incidence ranged between 0-100% of samples in different regions with an average value of 29.4% and aflatoxin concentrations of up to 6075 µg/kg recorded in one sample. Several regression techniques were explored. Random forests achieved the highest overall accuracy of 80%, while the accuracy of a logistic regression model was 65%. Low rainfall occurring during the early stage of the maize plant maturing combined with high temperatures leading up to full maturity provide warning signs of aflatoxin contamination. Risk maps for the two countries for the 2013 season were generated using both random forests and logistic regression models.

Improved methods for biomarker analysis of the big five mycotoxins enables reliable exposure characterization in a population of childbearing age women in Rwanda

Of the five agriculturally important mycotoxins, AFB₁, FB₁, DON, ZEA and OTA, a well-characterized biomarker of exposure in blood is only available for aflatoxin. Working with a population of 139 women of childbearing age in Rwanda, we undertook a comprehensive assessment of their dietary mycotoxin exposure. Using high-resolution LC-MS/MS with stable isotope dilution analysis, the albumin-aflatoxin adduct was quantitated in plasma. Similarly, AFM₁, AFB₁, AFG₁, FB₁ and B₂, OTA, zearalenone, α-zearalenol, deoxynivalenol, deoxynivalenol-15-glucuronide and deoxynivalenol-3-glucuronide were quantitated in urine. AFB₁-Lys was detected in plasma from 81% of the women, indicative of exposures 1-2 orders of magnitude above current guidance. Zearalenone and/or α-zearalenol were detected in the urine of 61% of the women, the majority of whom had estimated exposures 2-5 times the PMTDI, with one third more than an order of magnitude above. Urinary deoxynivalenol or the two glucuronide conjugates were found in 77% of the participants. Of these, 60% were below the PMTDI, 28% were twice and 12% were >10x the PMTDI. Fumonisin B₁ (30%) and ochratoxin A (71%) were also detected in urine. Exposures observed in these Rwandan women raise serious food safety concerns and highlight the need for authorities to help manage multiple mycotoxins in their diet.

Effect of Temperature, Water Activity and Carbon Dioxide on Fungal Growth and Mycotoxin Production of Acclimatised Isolates of Fusarium verticillioides and F. graminearum

Climate change is primarily manifested by elevated temperature and carbon dioxide (CO₂) levels and is projected to provide suitable cultivation grounds for pests and pathogens in the otherwise unsuitable regions. The impacts of climate change have been predicted in many parts of the world, which could threaten global food safety and food security. The aim of the present work was therefore to examine the interacting effects of water activity (a_w) (0.92, 0.95, 0.98 a_w), CO₂ (400, 800, 1200 ppm) and temperature (30, 35 °C and 30, 33 °C for Fusarium verticillioides and F. graminearum, respectively) on fungal growth and mycotoxin production of acclimatised isolates of F. verticillioides and F. graminearum isolated from maize. To determine fungal growth, the colony diameters were measured on days 1, 3, 5, and 7. The mycotoxins produced were quantified using a quadrupole-time-of-flight mass spectrometer (QTOF-MS) combined with ultra-high-performance liquid chromatography (UHPLC) system. For F. verticillioides, the optimum conditions for growth of fumonisin B₁ (FB₁), and fumonisin B₂ (FB₂) were 30 °C + 0.98 a_w + 400 ppm CO₂. These conditions were also optimum for F. graminearum growth, and zearalenone (ZEA) and deoxynivalenol (DON) production. Since 30 °C and 400 ppm CO₂ were the baseline treatments, it was hence concluded that the elevated temperature and CO₂ levels tested did not seem to significantly impact fungal growth and mycotoxin production of acclimatised Fusarium isolates. To the best of our knowledge thus far, the present work described for the first time the effects of simulated climate change conditions on fungal growth and mycotoxin production of acclimatised isolates of F. verticillioides and F. graminearum.

A Review of the Methodology of Analyzing Aflatoxin and Fumonisin in Single Corn Kernels and the Potential Impacts of These Methods on Food Security

Current detection methods for contamination of aflatoxin and fumonisin used in the corn industry are based on bulk level. However, literature demonstrates that contamination of these mycotoxins is highly skewed and bulk samples do not always represent accurately the overall contamination in a batch of corn. Single kernel analysis can provide an insightful level of analysis of the contamination of aflatoxin and fumonisin, as well as suggest a possible remediation to the skewness present in bulk detection. Current literature describes analytical methods capable of detecting aflatoxin and fumonisin at a single kernel level, such as liquid chromatography, fluorescence imaging, and reflectance imaging. These methods could provide tools to classify mycotoxin contaminated kernels and study potential co-occurrence of aflatoxin and fumonisin. Analysis at a single kernel level could provide a solution to the skewness present in mycotoxin contamination detection and offer improved remediation methods through sorting that could impact food security and management of food waste.

Aflatoxins: Producing-Molds, Structure, Health Issues and Incidence in Southeast Asian and Sub-Saharan African Countries

This review aims to update the main aspects of aflatoxin production, occurrence and incidence in selected countries, and associated aflatoxicosis outbreaks. Means to reduce aflatoxin incidence in crops were also presented, with an emphasis on the environmentally-friendly technology using atoxigenic strains of Aspergillus flavus. Aflatoxins are unavoidable widespread natural contaminants of foods and feeds with serious impacts on health, agricultural and livestock productivity, and food safety. They are secondary metabolites produced by Aspergillus species distributed on three main sections of the genus (section Flavi, section Ochraceorosei, and section Nidulantes). Poor economic status of a country exacerbates the risk and the extent of crop contamination due to faulty storage conditions that are usually suitable for mold growth and mycotoxin production: temperature of 22 to 29 °C and water activity of 0.90 to 0.99. This situation paralleled the prevalence of high liver cancer and the occasional acute aflatoxicosis episodes that have been associated with these regions. Risk assessment studies revealed that Southeast Asian (SEA) and Sub-Saharan African (SSA) countries remain at high risk and that, apart from the regulatory standards revision to be more restrictive, other actions to prevent or decontaminate crops are to be taken for adequate public health protection. Indeed, a review of publications on the incidence of aflatoxins in selected foods and feeds from countries whose crops are classically known for their highest contamination with aflatoxins, reveals that despite the intensive efforts made to reduce such an incidence, there has been no clear tendency, with the possible exception of South Africa, towards sustained improvements. Nonetheless, a global risk assessment of the new situation regarding crop contamination with aflatoxins by international organizations with the required expertise is suggested to appraise where we stand presently.

Postharvest Storage Practices of Maize in Rift Valley and Lower Eastern Regions of Kenya: A Cross-Sectional Study

An assessment of local farmers' knowledge, attitude, and practices on postharvest maize storage and management was carried out with a view of understanding its role in maize contamination with mycotoxins and postharvest losses in Rift Valley and Lower Eastern Regions of Kenya among 165 and 149 farmers, respectively. Differences between the two regions were analyzed using the Chi-square test, Fisher exact test, and two-sample t-test. The median quantity of maize harvested by farmers in the two regions after shelling was 585 kg. A median of 20 kg of maize was put aside as a result of rotting before shelling, and there was a significant mean difference in maize set aside as a result of rotting between the two regions (107.88 kg vs. 31.96 kg; t (306.25) = 5.707, P value <0.001). The quantity of discoloured and mouldy maize consumed ranged from 0 to 90 kg; 7 (2.2%) respondents consumed mouldy maize, 36 (11.5%) fed it to cows, and 19 (6.1%) fed it to poultry. A small percentage (3.5%) believed mouldy maize is safe for human consumption, 23.6% for animal consumption, while 15.0% considered it safe for brewing, with the differences between the two regions being statistically significant (P value <0.05). Nearly half of the respondents (48.4%) kept maize on cobs indoors, 47.1% left it in the field without covering, and 33.1% consumed and sold maize while still green, with more farmers from Lower Eastern practicing this. The results of the study suggest that there were poor postharvest practices and low awareness levels among maize farmers and that this can lead to postharvest losses due to Fusarium spp. infection and mycotoxin contamination that poses a threat to human and animal food safety. This calls for interventions on better postharvest practices.

Dietary determinants of aflatoxin B1-lysine adduct in pregnant women consuming a rice-dominated diet in Nepal

Background

Aflatoxins are found in diverse foods widely consumed worldwide. This study investigated the association between aflatoxin exposure and (a) consumption of specific foods, (b) dietary diversity (DD), and (c) seasonality.

Methods

Women enrolled in the AflaCohort Study in Banke, Nepal (n = 1648) were asked how often they ate certain food items in the past 7 days and 24 h. Serum aflatoxin B₁-lysine (AFB₁-lys) adduct levels, measured during pregnancy, were determined using high-performance liquid chromatography. Multivariable ordinary least squares and quantile regression models were used to examine incremental increases in AFB₁-lys adduct levels per frequency of food consumption and the relationship between DD, seasonality, and increases in AFB₁-lys adduct.

Results

Roughly 94% of women were exposed to aflatoxin (geometric mean 1.37 pg/mg). Women in the 30th, 50th, and 70th quantiles of aflatoxin exposure who reported one more occasion of maize consumption in the past week showed increases in AFB₁-lys adduct levels: 0.094, 0.112, and 0.109 pg/mg (p < 0.05, all). Women in the 30th, 50th, 70th, and 90th quantiles of exposure who reported one more occasion of groundnut consumption in the past week also showed increases in AFB₁-lys adduct levels: 0.058 (p < 0.001), 0.085 (p < 0.01), 0.133 (p < 0.001), and 0.133 (p < 0.001) pg/mg. Winter month recruitment was positively associated with AFB₁-lys adduct levels at all quantiles of aflatoxin exposure (range: 0.313–1.101 pg/mg, p < 0.001). DD was not predictive of aflatoxin exposure.

Conclusions

Our findings justify integrated approaches to aflatoxin reduction, including regulatory, agricultural, and food safety interventions across the value chain and at the household level.

Genomics-assisted breeding for ear rot resistances and reduced mycotoxin contamination in maize: methods, advances and prospects

Genetic mapping, genomic profiling and bioinformatic approaches were used to identify putative resistance genes for ear rots and low mycotoxin contamination in maize. Genomic selection seems to have good perspectives. Maize is globally an indispensable crop for humans and livestock. About 30% of yield is lost by fungal diseases with Gibberella, Fusarium and Aspergillus ear rots (ERs) having a high economic impact in most maize-growing regions of the world. They reduce not only yield, but also contaminate grains with mycotoxins like deoxynivalenol, zearalenone, fumonisins and aflatoxins, respectively. These mycotoxins pose serious health problems to humans and animals. A number of studies have been conducted to dissect the genetic architecture of resistance to these three major ear rots over the past decade. The review concentrates on studies carried out to locate quantitative trait loci (QTL) and candidate genes (CG) on the maize genome as well as the application of genomic selection in maize for resistance against Fusarium graminearum, Fusarium verticillioides and Aspergillus flavus. QTL studies by linkage or genome-wide association mapping, omic technologies (genomics, proteomics, transcriptomics and metabolomics) and bioinformatics are the methods used in the current studies to propose resistance genes against ear rot pathogens. Though a number of QTL and CG are reported, only a few specific genes were found to directly confer ER resistance in maize. A combination of two or more gene identification methods would provide a more powerful and reliable tool. Genomic selection seems to be promising for ER resistance breeding, but there are only a limited number of studies in this area. A strategy that can accurately validate and predict genotypes with major effect QTL and CG for selection will be worthwhile for practical breeding against ERs and mycotoxin contamination in maize.

Aflatoxin levels in maize and peanut and blood in women and children: The case of Timor-Leste

Aflatoxins are toxic fungal metabolites produced by Aspergillus sp. with carcinogenic properties that are a common food contaminant of many crops including maize and peanuts. In Timor-Leste malnutrition and children's stunting are frequent and maize and peanuts are staple foods. This study aimed to provide information on aflatoxin exposure nationally. The study measured levels of aflatoxin in locally-produced maize and peanuts (296 samples) and of aflatoxin-albumin conjugate in blood samples of women and young children (514 and 620 respectively) across all municipalities. The average concentration of aflatoxin in the grain samples was low with most maize (88%) and peanut (92%) samples - lower than European Commission tolerated aflatoxin level. Although aflatoxin-albumin conjugate was detected in more than 80% of blood samples, the average concentration in children and adults of 0.64 and 0.98 pg mg^-1 alb, respectively, is much lower than in other similar rural-based countries. Although low in concentration, blood aflatoxin levels and aflatoxin contamination levels in maize across municipalities were correlated significantly for mothers (R² = 37%, n = 495) but not for children (R² = 10%). It is unlikely that the consumption of aflatoxin contaminated grain is a causative factor in the current level of malnutrition and stunting affecting Timor-Leste children.

Mycotoxin occurrence in Peruvian purple maize

The presence of mycotoxins in 82 samples of Peruvian purple maize was determined by LC-MS/MS methods. Samples were collected from local commercial establishments in Peru from December 2015 to March 2016, and from March 2017 to April 2017. Aflatoxins (AF) (64.6%) and fumonisins (FB) (63.4%) were the most common mycotoxins, with average values of 2.1 (1-17) and 2,586 (125-27,490) μg/kg, respectively. Zearalenone (ZEA) was identified in a single sample at 24.4 μg/kg. Co-occurrence of AF and FB was confirmed in 45.1% of the samples (n=37), which presented significant (P<0.05) Spearman correlation (ρ=0.59) between these mycotoxins. Co-occurrence of AF, FB and ZEA was found in one sample and ZEA was found in one sample. Ochratoxin A, deoxynivalenol, nivalenol, fusarenone X, diacetoxyscirpenol, 3-acetyldeoxinivalenol, HT-2 toxin and T-2 toxin were not detected. Water activity (Aw) of these samples exceeded 0.73; there was no correlation between Aw and the levels of mycotoxins. This is the first study to evaluate the occurrence of mycotoxins in Peruvian purple maize, and it ascertained that this variety may pose a risk to public health. Therefore, there is a need to control this grain supply chain in order to determine the factors involved in the presence of these toxins, and to establish regulatory limits or guidelines for maximum tolerated levels.

Rural Subsistence Maize Farming in South Africa: Risk Assessment and Intervention models for Reduction of Exposure to Fumonisin Mycotoxins

Maize is a staple crop in rural subsistence regions of southern Africa, is mainly produced for direct household consumption and is often contaminated with high levels of mycotoxins. Chronic exposure to mycotoxins is a risk factor for human diseases as it is implicated in the development of cancer, neural tube defects as well as stunting in children. Although authorities may set maximum levels, these regulations are not effective in subsistence farming communities. As maize is consumed in large quantities, exposure to mycotoxins will surpass safe levels even where the contamination levels are below the regulated maximum levels. It is clear that the lowering of exposure in these communities requires an integrated approach. Detailed understanding of agricultural practices, mycotoxin occurrence, climate change/weather patterns, human exposure and risk are warranted to guide adequate intervention programmes. Risk communication and creating awareness in affected communities are also critical. A range of biologically based products for control of mycotoxigenic fungi and mycotoxins in maize have been developed and commercialised. Application of these methods is limited due to a lack of infrastructure and resources. Other challenges regarding integration and sustainability of technological and community-based mycotoxin reduction strategies include (i) food security, and (ii) the traditional use of mouldy maize.

Enhancing Food Safety through Adoption of Long-Term Technical Advisory, Financial, and Storage Support Services in Maize Growing Areas of East Africa

Grain production and storage are major components in food security. In the ancient times, food security was achieved through gathering of fruits, grains, herbs, tubers, and roots from the forests by individual households. Advancements in human civilization led to domestication of crops and a need to save food for not only a household, but the nation. This extended need for food security led to establishment of national reservoirs for major produces and this practice varies greatly in different states. Each of the applied food production, handling, and storage approaches has its benefits and challenges. In sub-Saharan Africa, several countries have a public funded budget to subsidize production costs, to buy grains from farmers, and to store the produce for a specific period and/or until the next harvests. During the times of famine, the stored grains are later sold at subsidized prices or are given for free to the starving citizens. If there is no famine, the grain is sold to retailers and/or processors (e.g., millers) who later sell it to the consumers. This approach works well if the produce (mainly grain) is stored under conditions that do not favor growth of molds, as some of these microbes could contaminate the grain with toxic and carcinogenic metabolites called mycotoxins. Conditions that alleviate contamination of grains are required during production, handling, and storage. Most of the grain is produced by smallholder farmers under sub-optimal conditions, making it vulnerable to colonization and contamination by toxigenic fungi. Further, the grain is stored in silos at large masses, where it is hard to monitor the conditions at different points of these facilities, and hence, it becomes vulnerable to additional contamination. Production and storage of grain under conditions that favor mycotoxins poses major food health and safety risks to humans and livestock who consume it. This concept paper focuses on how establishment of a local grain production and banking system (LGPBS) could enhance food security and safety in East Africa. The concept of LGPBS provides an extension of advisory and finance support within warehouse receipt system to enhance grain production under optimal conditions. The major practices at the LGPBS and how each could contribute to food security and safety are discussed. While the concept paper gives more strength on maize production and safety, similar practices could be applied to enhance safety of other grains in the same LGPBS.

Assessment of Aflatoxin and Fumonisin Contamination and Associated Risk Factors in Feed and Feed Ingredients in Rwanda

Mycotoxins are fungal metabolites that contaminate crops, food, and animal feeds. Aflatoxins and fumonisins are among the mycotoxins that have been increasingly reported to affect health and productivity of livestock globally. Given that the health and productivity of livestock can directly influence human food safety and security, a study was conducted to assess the levels and factors for aflatoxin and fumonisin contamination in feed and feed ingredients in Rwanda. Aflatoxins and fumonisins were analyzed in 3328 feed and feed ingredient samples collected at six time points between March and October 2017 in all 30 districts of Rwanda. Of the 612 participants providing samples, there were 10 feed processors, 68 feed vendors, 225 dairy farmers, and 309 poultry farmers. Enzyme-Linked Immunosorbent Assay (ELISA) was used for aflatoxin and fumonisin analyses. Mean aflatoxin levels of 108.83 µg/kg (Median (MD): 43.65 µg/kg), 103.81µg/kg (MD: 48.4 µg/kg), 88.64 µg/kg (MD: 30.90 µg/kg), and 94.95 µg/kg (MD: 70.45 µg/kg) were determined for dairy farmers, poultry farmers, feed vendors, and feed processors, respectively. Mean fumonisin levels were 1.52 mg/kg (MD: 0.71 mg/kg), 1.21 mg/kg (MD: 0.56 mg/kg), 1.48 mg/kg (MD: 0.76 mg/kg), and 1.03 mg/kg (MD: 0.47 mg/kg) for dairy farmers, poultry farmers, feed vendors, and feed processors, respectively. Aflatoxin contamination was significantly affected by time of sampling and district from which feed samples originated (p < 0.05). Fumonisins did not show any correlation trends. Ninety-two percent of survey participants were unaware of aflatoxins and fumonisins and their adverse effects. This study has provided the basic understanding of the extent of feed contamination across the country and has established a baseline for future interventions in Rwanda. Further studies are needed to explore strategies for mitigating mycotoxins in the feed value chain in Rwanda.

Inadequate management of complementary foods contributes to the risk of aflatoxin exposure and low nutrition status among children

Early exposure to aflatoxins through complementary food is linked to impaired growth in childhood. The current study assessed the household’s practices on management of complementary foods in relation to the risk of aflatoxin exposure and poor nutritional status among infant and young children in Tanzania. A cross-sectional study of complementary feeding practices, aflatoxin exposure and nutritional status was conducted to 101 infants and young children aged between 6-23 months in Dodoma region of Tanzania. The intake of complementary food was estimated by using repeated 24 h dietary recall. Flour used as complementary food was sampled from each of the 101 families and aflatoxins were analysed using high-performance liquid chromatography. A deterministic approach was used to estimate dietary exposure of aflatoxins in the complementary foods. Anthropometric measurements were taken and rates of stunting, underweight and wasting estimated according to the WHO standard procedures. Multivariate logistic regression analysis was used to assess the association between feeding practices and aflatoxin exposure or the growth performance among subjects. The average consumption of complementary flour was 118 g per child per day and 52% of the flours contained groundnuts. AFB1 was detected in 42.5% of the flour and levels ranged from 0.3 to 2,128.0 μg/kg (mean 228.11±49.84 μg/kg). Dietary exposures of aflatoxin B1 ranged from 0.1 to 23,172.81 ng/kg body weight per day (mean 1,337±392.5 ng/kg). Of the subjects, 40.4% (95% CI; 29.8; 50.9) were stunted and significant association was found between stunted growth and dietary exposure of AFB1 (adjusted odd ratio (AOR)=5.9; 95% CI: 0.019-0.028). Early introduction of cereal-and groundnut-based complementary foods in Tanzania is associated with high risk of aflatoxin exposure and impaired growth in children. There is need to integrate aflatoxin management measures in the guidelines for Infant and Young Children Feeding of Tanzania.

Post-harvest interventions decrease aflatoxin and fumonisin contamination in maize and subsequent dietary exposure in Tanzanian infants: a cluster randomised-controlled trial

A cluster randomised controlled trial was performed in three agro-ecological zones of Tanzania to evaluate the effectiveness of locally available post-harvest mitigation strategies in preventing and reducing aflatoxin and fumonisin contamination in maize. A total of 300 children, each from one household, were randomly selected from 30 villages (intervention: n=15). The mitigation strategies focused on hand sorting (prior to storage and use), drying maize on mat/raised platforms, proper sun drying, application of storage insecticides and de-hulling before milling. Maize sample was collected from each household at harvest (baseline) and six months after harvest. Maize intake by each child, estimated using the 24 h dietary recall technique and its body weight measured using standard procedures were taken at six months after harvest. Aflatoxins and fumonisins in the maize samples were determined using HPLC. Follow-up (six month after harvest) data were available for 261 of the 300 households (intervention: n=136). Mean concentration of aflatoxins, or fumonisins was significantly (P<0.05) lower in the intervention than in the control group: intervention effects: μg/kg (95% confidence interval (CI)) -4.9 (-7.3,-2.5), and -405, (-647,-162), respectively. The difference corresponds to 83 and 70% for aflatoxins, and fumonisins, respectively. At the end of the intervention, aflatoxin and fumonisin estimated mean intakes were lower in the intervention than in the control group by 78 and 65%, respectively. Six months after harvest, prevalence of underweight in the intervention group was 6.7% lower (P=0.014) than in the control group. Mean weight-for-age Z-score difference between the groups was 0.57 (95% CI; 0.16,-0.98; P=0.007). Post-harvest practices are effective in preventing and reducing aflatoxin and fumonisin contamination in maize and subsequent dietary exposure to infants. The interventions may be applied in these and other communities with similar environmental conditions or agricultural practices that favour production of aflatoxin and fumonisins in food crops. The trial was registered at ClinicalTrials.gov identifier: NCT02438774.

Effect of agronomic practices and weather conditions on mycotoxins in maize: a case study of subsistence farming households in Zimbabwe

Maize is susceptible to many mycotoxigenic fungi and mycotoxins, being prone to Fusarium spp. infection and subsequent mycotoxin contamination. Fumonisin B1 (FB1) is the predominant mycotoxin in Zimbabwean subsistence-grown maize and results of mycotoxin analyses indicated FB1 to be significantly higher compared to other mycotoxins. To fully elucidate maize agronomic practices influencing FB1 contamination of maize produced by Zimbabwean subsistence farming populations, an investigative field survey was conducted in the selected provinces of Mashonaland West and Manicaland. Agronomic data and associated climatic data were collected during the 2014/2015 agricultural season. A total of 158 maize samples were collected from households’ harvest, three months and six months post-harvest. Analysis and quantification of mycotoxin contamination in the maize samples was performed using a validated multi-mycotoxin analysis method with a scope of 23 mycotoxins. Maize was mainly contaminated by FB1. There was low mycotoxin co-occurrence in Zimbabwean maize, which was typically of Fusarium toxins. FB1 occurred in 23, 47 and 47% of samples at harvest, three and six months post-harvest, respectively. The corresponding means of positive samples were 609, 597 and 289 μg/kg, respectively. Regarding fumonisins, the choice of seed and fertiliser application were significant in modulating FB1 contamination. There was no significant difference in mean FB1 contamination during post-harvest maize storage. Daily temperatures were key factors influencing FB1 incidence and levels. High temperatures were associated with high FB1 contamination particularly at the flowering stage of maize. Rainfall was positively correlated with FB1 contamination. Good agricultural practices attributed to low FB1 contamination in maize pre-harvest. Post-harvest practices such as preserving seed integrity by preventing pest infestation using grain protection chemicals are important in achieving lower mycotoxin contamination and in particular, FB1, in maize grain.

Outbreak of an acute aflatoxicosis in Tanzania during 2016

In June 2016, an outbreak of an unknown disease was reported to affect clusters of families in two regions of the central part of Tanzania. A rapid epidemiological survey was conducted in the affected villages, with a detailed house-to-house survey in selected households. A total of 68 cases occurred between 14 May and 14 November 2016, of which 20 died, making a case fatality rate of 30%. Over 50% of the cases were below the age of 15 years. The cases presented with jaundice (n=60), abdominal pain (n=59), vomiting (n=56), diarrhoea (n=34) and ascites (n=32). The responsible food item appeared to be home grown maize. The rate ratio indicated that the occurrence of illnesses was associated with ingestion of food contaminated with high levels of aflatoxins (contamination range: 10-51,100 μg/kg and 2.4-285 μg/kg for case and control households, respectively). Serum aflatoxin biomarker indicated that cases were more likely to have higher than 1000 pg/mg aflatoxin-albumin adduct level in their sera compared to controls (Odds Ratio = 13.5; 95% confidence intervals = 1.5-165.3; range of aflatoxin-albumin adduct level = 36- 32,800 pg/mg for cases and 10-4020 pg/mg for controls). Beside aflatoxins, maize samples were also contaminated with high levels of fumonisins (range of contamination; 945-12,630 μg/kg) with 8 of 10 samples analysed from case households co-contaminated with both toxins at levels above the maximum limit of 5 or 10 μg/kg set for AFB1 or total aflatoxins and 2,000 μg/kg for fumonisins. Clinical presentation and high levels of aflatoxin in food samples coupled with high levels of serum aflatoxin-albumin adducts among the cases support the causal role of aflatoxins.

Aflatoxin exposure assessed by aflatoxin albumin adduct biomarker in populations from six African countries: REVIEW ARTICLE

Aflatoxins are a group of carcinogenic mycotoxins that have been implicated to have other adverse health impacts, including child growth impairment and immune function suppression. Aflatoxin B₁ is the most toxic and most common of the aflatoxins. Contamination of various food crops is common in sub-Saharan Africa, particularly in staple crops such as maize and groundnuts, leading to chronic dietary exposure in many populations. For many years we have used the aflatoxin albumin adduct as a biomarker of aflatoxin exposure, assessed using a competitive inhibition enzyme linked immunosorbent assay (ELISA). Here, we review our recent studies of human exposure in six African countries; Gambia, Guinea, Kenya, Senegal, Tanzania and Uganda. This data shows the widespread exposure of vulnerable populations to aflatoxin. Geometric mean (95% confidence interval) levels of the biomarker ranged from 9.7 pg/mg (8.2, 11.5) in Ugandan children to 578.5 pg/mg (461.4, 717.6) in Kenyan adolescents during an acute aflatoxicosis outbreak year. We describe how various factors may have influenced the variation in aflatoxin exposure in our studies. Together, these studies highlight the urgent need for measures to reduce the burden of aflatoxin exposure in sub-Saharan Africa.

Control of Fusarium verticillioides (Sacc.) Nirenberg and Fumonisins by Using a Combination of Crop Protection Products and Fertilization

Fusarium verticillioides is the most common fungal pathogen associated with maize ear rot in Tanzania. In a two-year trial, we investigated the efficacy of crop protection (insecticide and/or fungicide) and fertilizer (nitrogen and/or phosphorus) treatments in reducing the occurrence of F. verticillioides and its mycotoxins in maize grown in Tanzania. Seasonal differences were seen to have a substantial influence on the incidence and severity of insect infestation, Fusarium ear and kernel rot, biomass of F. verticillioides and contamination with fumonisins. With regard to the application of fertilizers, it was concluded that the impact on maize stalk borer injury, Fusarium symptoms and fumonisin levels was not significant, whereas crop protection significantly reduced maize damage. The application of an insecticide was most effective in reducing insect injury and as a result of the reduced insect injury the insecticide treatment also resulted in a significant decrease in Fusarium symptoms. In 2014, fumonisin levels were also significantly lower in maize treated with an insecticide. Additionally, significant positive correlations between insect damage and Fusarium symptoms were observed. In conclusion, this study clearly shows that application of an insecticide alone or in combination with a fungicide at anthesis significantly reduces insect damage and consequently reduces F. verticillioides infection and associated fumonisin contamination.

The association between infant and young child feeding practices and diarrhoea in Tanzanian children

BACKGROUND

Diarrhoea is a leading cause of child mortality in Tanzania. The association between optimal infant feeding practices and diarrhoea has been reported elsewhere, but the evidence has been limited to promote and advocate for strategic interventions in Tanzania. This study examined the association between infant and young child feeding (IYCF) practices and diarrhoea in Tanzanian children under 24 months.

METHODS

The study used the Tanzania Demographic and Health Survey data to estimate the prevalence of diarrhoea stratified by IYCF practices. Using multivariable logistic regression modelling that adjusted for confounding factors and cluster variability, the association between IYCF practices and diarrhoea among Tanzanian children was investigated.

RESULTS

Diarrhoea prevalence was lower in infants aged 0-5 months whose mothers engaged in exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) compared to those who were not exclusively and predominantly breastfed. Infants aged 6-8 months who were introduced to complementary foods had a higher prevalence of diarrhoea compared to those who received no complementary foods, that is, infants who were exclusively breastfed at 6-8 months. Infants who were exclusively and predominantly breastfed were less likely to experience diarrhoea compared to those who were not exclusively and predominantly breastfed [adjusted odds ratio (AOR) 0.31, 95% confidence interval (CI) 0.16-0.59, P < 0.001 for EBF and AOR = 0.30, 95% CI 0.10-0.89, P = 0.031 for PBF]. In contrast, infants aged 6-8 months who were introduced to complementary foods were more likely to experience diarrhoea compared to those who received no complementary foods (AOR = 2.91, 95% CI 1.99-4.27, P < 0.001).

CONCLUSIONS

The study suggests that EBF and PBF were protective against diarrhoeal illness in Tanzanian children, while the introduction of complementary foods was associated with the onset of diarrhoea. Strengthening IYCF (facility- and community-based) programmes would help to improve feeding behaviours of Tanzanian women and reduce diarrhoea burden in children under 2 years.

Occurrence of aflatoxins and its management in diverse cropping systems of central Tanzania

The staple crops, maize, sorghum, bambara nut, groundnut, and sunflower common in semi-arid agro-pastoral farming systems of central Tanzania are prone to aflatoxin contamination. Consumption of such crop produce, contaminated with high levels of aflatoxin B1 (AFB1), affects growth and health. In this paper, aflatoxin contamination in freshly harvested and stored crop produce from central Tanzania was examined, including the efficacy of aflatoxin mitigation technologies on grain/kernal quality. A total of 312 farmers were recruited, trained on aflatoxin mitigation technologies, and allowed to deploy the technologies for 2 years. After 2 years, 188 of the 312 farmers were tracked to determine whether they had adopted and complied with the mitigation practices. Aflatoxigenic Aspergillus flavus and aflatoxin B1 contamination in freshly harvested and stored grains/kernels were assessed. A. flavus frequency and aflatoxin production by fungi were assayed by examining culture characteristics and thin-layer chromatography respectively. AFB1 was assayed by enzyme-linked immunosorbent assay. The average aflatoxin contamination in freshly harvested samples was 18.8 μg/kg, which is above the acceptable standard of 10 μg/kg. Contamination increased during storage to an average of 57.2 μg/kg, indicating a high exposure risk. Grains and oilseeds from maize, sorghum, and sunflower produced in aboveground reproductive structures had relatively low aflatoxin contamination compared to those produced in geocarpic structures of groundnut and bambara nut. Farmers who adopted recommended post-harvest management practices had considerably lower aflatoxin contamination in their stored kernels/grains. Furthermore, the effects of these factors were quantified by multivariate statistical analyses. Training and behavioral changes by farmers in their post-harvest practice minimize aflatoxin contamination and improve food safety. Moreover, if non-trained farmers receive mitigation training, aflatoxin concentration is predicted to decrease by 28.9 μg/kg on average.

Engaging One Health for Non-Communicable Diseases in Africa: Perspective for Mycotoxins

The role of mycotoxins-e.g., aflatoxins, ochratoxins, trichothecenes, zearalenone, fumonisins, tremorgenic toxins, and ergot alkaloids-has been recognized in the etiology of a number of diseases. In many African countries, the public health impact of chronic (indoor) and/or repeated (dietary) mycotoxin exposure is largely ignored hitherto, with impact on human health, food security, and export of African agricultural food products. Notwithstanding, African scientific research reached milestones that, when linked to findings gained by the international scientific community, make the design and implementation of science-driven governance schemes feasible. Starting from Nigeria as leading African Country, this article (i) overviews available data on mycotoxins exposure in Africa; (ii) discusses new food safety issues, such as the environment-feed-food chain and toxic exposures of food producing animals in risk assessment and management; (iii) identifies milestones for mycotoxins risk management already reached in West Africa; and (iv) points out preliminary operationalization aspects for shielding communities from direct (on health) and indirect (on trade, economies, and livelihoods) effects of mycotoxins. An African science-driven engaging of scientific knowledge by development actors is expected therefore. In particular, One health/One prevention is suggested, as it proved to be a strategic and sustainable development framework.