Aflatoxin in household maize for human consumption in Kenya, East Africa

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.

Baicalin attenuates aflatoxin B1-induced hepatotoxicity via suppressing c-Jun-N-terminal kinase-mediated cell apoptosis

Aflatoxin B1 (AFB1) is classified as a Class I carcinogen and common pollutant in human and animal food products. Prolonged exposure to AFB1 can induce hepatocyte apoptosis and lead to hepatotoxicity. Therefore, preventing AFB1-induced hepatotoxicity remains a critical issue and is of great significance. Baicalin, a polyphenolic compound derived from Scutellaria baicalensis Georgi, has a variety of pharmacodynamic activities, such as antiapoptotic and anticancer activities. This study systematically investigated the alleviating effect of baicalin on AFB1-induced hepatotoxicity from the perspective of apoptosis and explored the possible molecular mechanism. In the normal human liver cell line L02, baicalin treatment significantly inhibited AFB1-induced c-Jun-N-terminal Kinase (JNK) activation and cell apoptosis. In addition, the in vitro mechanism study demonstrated that baicalin alleviates AFB1-induced hepatocyte apoptosis through suppressing the translocation of phosphorylated JNK to the nucleus and decreasing the phosphorylated c-Jun/c-Jun ratio and the Bax/Bcl2 ratio. Molecular docking and drug affinity responsive target stability assays demonstrated that baicalin has the potential to target JNK. This study provides a basis for the therapeutic effect of baicalin on hepatocyte apoptosis caused by AFB1, indicating that the development of baicalin and JNK pathway inhibitors has broad application prospects in the prevention of hepatotoxicity, especially hepatocyte apoptosis.

Recent Advances in Non-Contact Food Decontamination Technologies for Removing Mycotoxins and Fungal Contaminants

Agricultural food commodities are highly susceptible to contamination by fungi and mycotoxins, which cause great economic losses and threaten public health. New technologies such as gamma ray irradiation, ultraviolet radiation, electron beam irradiation, microwave irradiation, pulsed light, pulsed electric fields, plasma, ozone, etc. can solve the problem of fungal and mycotoxin contamination which cannot be effectively solved by traditional food processing methods. This paper summarizes recent advancements in emerging food decontamination technologies used to control various fungi and their associated toxin contamination in food. It discusses the problems and challenges faced by the various methods currently used to control mycotoxins, looks forward to the new trends in the development of mycotoxin degradation methods in the future food industry, and proposes new research directions.

Comprehensive Review of Aflatoxin and Ochratoxin A Dynamics: Emergence, Toxicological Impact, and Advanced Control Strategies

Filamentous fungi exhibit remarkable adaptability to diverse substrates and can synthesize a plethora of secondary metabolites. These metabolites, produced in response to environmental stimuli, not only confer selective advantages but also encompass potentially deleterious mycotoxins. Mycotoxins, exemplified by those originating from Alternaria, Aspergillus, Penicillium, and Fusarium species, represent challenging hazards to both human and animal health, thus warranting stringent regulatory control. Despite regulatory frameworks, mycotoxin contamination remains a pressing global challenge, particularly within cereal-based matrices and their derived by-products, integral components of animal diets. Strategies aimed at mitigating mycotoxin contamination encompass multifaceted approaches, including biological control modalities, detoxification procedures, and innovative interventions like essential oils. However, hurdles persist, underscoring the imperative for innovative interventions. This review elucidated the prevalence, health ramifications, regulatory paradigms, and evolving preventive strategies about two prominent mycotoxins, aflatoxins and ochratoxin A. Furthermore, it explored the emergence of new fungal species, and biocontrol methods using lactic acid bacteria and essential mustard oil, emphasizing their efficacy in mitigating fungal spoilage and mycotoxin production. Through an integrative examination of these facets, this review endeavored to furnish a comprehensive understanding of the multifaceted challenges posed by mycotoxin contamination and the emergent strategies poised to ameliorate its impact on food and feed safety.

Aflatoxins in maize flour produced in Mozambique and its risk assessment

This study investigated the occurrence of aflatoxins (B1, B2, G1, and G2) in maize flour produced in Mozambique and to assess the associated carcinogenic risk. At different opportunities, 30 samples of maize flour were collected in five flour processing factories. These were determined by high-performance liquid chromatography (HPLC) with fluorescence detection. AFB1 concentrations ranged from 0.25 to 0.33 μg kg-1. The levels of total aflatoxins ranged from 0.55 to 1.05 μg kg-1, with a mean of 0.89 μg kg-1, for which maximum limits (MLs) are 10 and 4 μg kg-1 for Mozambique and the European Union, respectively. The calculated Margin of Exposure (MOE) for men and women was 243 and 231, respectively, so several folds below the risk cut-off level, indicating that consumption of such maize flour poses a potential risk of hepatocarcinoma related to aflatoxin exposure due to high intake of this food, a staple diet in most African countries.

Aflatoxin Contamination, Exposure among Rural Smallholder Farming Tanzanian Mothers and Associations with Growth among Their Children

Recently, aflatoxin exposure especially through maize and groundnuts has been associated with growth impairment in children. Infants and children are considered to be more susceptible to toxins because of their lower body weight, higher metabolic rate, and lower ability to detoxify. On the other hand, for women of reproductive age, aflatoxin exposure may not only affect their health but also that of their foetus in the case of pregnancy. This study focused on investigating AFB1 contamination in maize and groundnut from respondent households, exposure among women of reproductive age and associations of aflatoxin contamination with growth retardation among children in Mtwara region, Tanzania. The highest maximum AFB1 contamination levels from all samples obtained were in maize grain (2351.5 μg/kg). From a total of 217 maize samples collected, aflatoxins were above European Union (EU) and East African Community (EAC) tolerable limits in 76.0% and 64.5% of all samples. Specifically, maize grain had the highest proportion of samples contaminated above tolerable limits (80.3% and 71.1% for EU and EAC limits). Groundnut had 54.0% and 37.9% of samples above EU and EAC maximum tolerable limits. The lowest proportion of contaminated samples on the other hand was for bambara nut (37.5% and 29.2% for EU and EAC limits, respectively). Aflatoxin exposure in our surveyed population was much higher than previous observations made in Tanzania and also higher than those observed in Western countries such as Australia and the USA. Among children, AFB1 concentration was associated with lower weight for height z scores and weight for age z scores in the univariate model (p < 0.05). In summary, these results indicate the seriousness of aflatoxin contamination in foods commonly consumed in the vulnerable population assessed. Strategies both from the health, trade, and nutrition sectors should therefore be designed and implemented to address aflatoxin and mycotoxin contamination in diets.

Dietary aflatoxin exposure of lactating mothers of children 0-6 months in Makueni County, Kenya

The southeastern region of Kenya is prone to aflatoxin outbreaks, yet maternal and infant aflatoxin intake levels remain unclear. We determined dietary aflatoxin exposure of 170 lactating mothers breastfeeding children aged 6 months and below in a descriptive cross-sectional study involving aflatoxin analysis of maize-based cooked food samples (n = 48). Their socioeconomic characteristics, food consumption patterns and postharvest handling of maize were determined. Aflatoxins were determined using high-performance liquid chromatography and enzyme-linked immunosorbent assay. Statistical analysis was conducted using Statistical Package Software for Social Sciences (SPSS version 27) and Palisade's @Risk software. About 46% of the mothers were from low-income households, and 48.2% had not attained the basic level of education. A generally low dietary diversity was reported among 54.1% of lactating mothers. Food consumption pattern was skewed towards starchy staples. Approximately 50% never treated their maize, and at least 20% stored their maize in containers that promote aflatoxin contamination. Aflatoxin was detected in 85.4% of food samples. The mean of total aflatoxin was 97.8 μg/kg (standard deviation [SD], 57.7), while aflatoxin B1 was 9.0 μg/kg (SD, 7.7). The mean dietary intake of total aflatoxin and aflatoxin B1 was 7.6 μg/kg/b.w.t/day (SD, 7.5) and 0.6 (SD, 0.6), respectively. Dietary aflatoxin exposure of lactating mothers was high (margin of exposure < 10,000). Sociodemographic characteristics, food consumption patterns and postharvest handling of maize variably influenced dietary aflatoxin exposure of the mothers. The high prevalence and presence of aflatoxin in foods of lactating mothers are a public health concern and calls for the need to devise easy-to-use household food safety and monitoring measures in the study area.

Exposure assessment of aflatoxins and zearalenone in edible vegetable oils in Shandong, China: health risks posed by mycotoxin immunotoxicity and reproductive toxicity in children

Human exposure to aflatoxins (AFs) and zearalenone (ZEA) has not been sufficiently investigated. Here, we analyzed the exposure level and health risks posed by AFs (B1, B2, G1, G2) and ZEA through cooking oil consumption in Shandong, China. The individual daily consumption of cooking oil was calculated through 2745 questionnaires during 2017-2019. The average contamination levels of mycotoxins were estimated by examining 60 cooking oil samples. For the peanut oil, AFs ranged from <0.2 to 274 μg/kg, with a positive rate of 66.6% (20/30). Average levels of 36.62 μg/kg AFB₁ and 44.43 μg/kg total AFs were found. Over-the-limit level (20 μg/kg) of AFB₁ was detected in 8/30 samples. Estimated daily intake (EDI) and margin of exposure (MOE) for age-stratified population groups showed that children are facing highest adverse health risk with AFB₁ (MOE 5.88-6.39). The liver cancer incidences attributable to AFB₁ exposure are non-negligible as 0.896, 0.825, and 0.767 cases per 100,000 for 6-14 age group, 15-17 age group, and adult labor-intensive workers. Over-the-limit level (60 μg/kg) ZEA contamination was detected in 25/30 corn oil samples with a 50th percentile value of 97.95 μg/kg. Our health risk assessment suggested significant health risks of enterohepatic (inflammation and cancer), reproductive, and endocrine systems posed by AFs and ZEA. However, the health risk of immunotoxicity is unclear because currently animal study data are not available for the immunotoxicity induced after long-term exposure. In general, the health risks posed by mycotoxins are non-negligible and long-term mycotoxin surveillance is necessary.

Aflatoxin in cereals and groundnut from small holder farming households in Malawi

Aflatoxin contamination in commonly consumed cereals and nuts may place children at higher risk of stunting and adults at risk of developing liver cancer. This study investigated knowledge on aflatoxins and the level of aflatoxin B₁ contamination in commonly consumed cereals and nuts in Malawi. It also included an examination of the proportion of cereals and nuts contaminated above regulatory maximum limits. Aflatoxin contamination in samples was assessed using an enzyme-linked immunosorbent assay (ELISA) method. Less than half of all households knew that consumption of aflatoxin contaminated grain is associated with stunting and lowered immunity. Sorghum samples were the most contaminated and millet the least contaminated. Aflatoxin contamination was highest in southern Malawi and least in northern Malawi. Observed results indicate that this population is at risk of poor health due to lack of knowledge and aflatoxin exposure. Strategies to address contamination should therefore include a comprehensive education campaign to increase knowledge and promote accessible strategies.

Effectiveness of citrus fruit peel as a biosorbent for the mitigation of aflatoxins in vitro

We assessed the effectiveness of novel and cost-effective citrus fruit peel (oranges, agro-waste material) for the removal of four aflatoxins B₁, B₂, G₁, and G₂ in vitro. The biosorbent was described using SEM, XRF, XRD, FITR spectroscopy, and point of zero charge. The adsorption performance was optimised in a batch experiment by altering the various parameters, such as biosorbent dose (1-15 mg/mL), the preliminary concentration of AFs (20-200 ng/mL), pH (1-9), the incubation period (10-60 min), and temperature (10-45 °C). Maximum removal (90%) was achieved when using biosorbent at 10 mg, each AF concentration 100 ng/mL, pH 3, and incubation time 45 min at 37 °C. The experimental data were well-described by the Langmuir isotherm model and the monolayer coverage (Qe) was calculated to be 78.5, 77.8, 79.2, and 75.6 ng/mg for aflatoxin B₁, B₂, G₁, and G₂, respectively. The thermodynamic and kinetic studies suggested that the adsorption performance was endothermic and obeyed the pseudo-second-order rate model. Studies at different pH also proved that the adsorption of toxins would be strong and sufficient under pH variation, as found in the gastrointestinal tract. Thus the biosorption of AFs by orange peel powder might be an efficient low price detoxification method in humans and animals.

Mycotoxins in food and feed: toxicity, preventive challenges, and advanced detection techniques for associated diseases

Mycotoxins are produced primarily as secondary fungal metabolites. Mycotoxins are toxic in nature and naturally produced by various species of fungi, which usually contaminate food and feed ingredients. The growth of these harmful fungi depends on several environmental factors, such as pH, humidity, and temperature; therefore, the mycotoxin distribution also varies among global geographical areas. Various rules and regulations regarding mycotoxins are imposed by the government bodies of each country, which are responsible for addressing global food and health security concerns. Despite this legislation, the incidence of mycotoxin contamination is continuously increasing. In this review, we discuss the geographical regulatory guidelines and recommendations that are implemented around the world to control mycotoxin contamination of food and feed products. Researchers and inventors from various parts of the world have reported several innovations for controlling mycotoxin-associated health consequences. Unfortunately, most of these techniques are restricted to laboratory scales and cannot reach users. Consequently, to date, no single device has been commercialized that can detect all mycotoxins that are naturally available in the environment. Therefore, in this study, we describe severe health hazards that are associated with mycotoxin exposure, their molecular signaling pathways and processes of toxicity, and their genotoxic and cytotoxic effects toward humans and animals. We also discuss recent developments in the construction of a sensitive and specific device that effectively implements mycotoxin identification and detection methods. In addition, our study comprehensively examines the recent advancements in the field for mitigating the health consequences and links them with the molecular and signaling pathways that are activated upon mycotoxin exposure.

Quality control and mycotoxin levels in food in the Palestinian market

A total of 51 food samples (18 rice, 17 wheat flour, and 16 nuts) were randomly collected from different shops and analysed for the presence of total aflatoxins, ochratoxin A and fumonisins, using a lateral flow competitive immunochromatographic assay method. Mycological contamination (total aerobic and fungi count), colour index (L*a*b*) and moisture content were also evaluated. Sensory characteristics for mycotoxins contaminated and uncontaminated samples of rice and wheat flour were evaluated by 40 panellists. Forty-five per cent of all samples were positive for aflatoxins as the most occurred mycotoxins, with a range of 2-8.1 μg/kg. Fungal counts were not significantly different between contaminated and uncontaminated rice and wheat flour samples. In addition, panellists were able to discriminate between contaminated and uncontaminated rice samples by detection of mouldy flavour, spoilage symptoms, earthy flavour, and the degree of freshness.

Aflatoxin B1 Induces Gut-Inflammation-Associated Fecal Lipidome Changes in F344 Rats

Aflatoxin B1 (AFB1) induced intestinal epithelial damage in rodent models, which indicates that long-term exposure to AFB1 may cause chronic gut disorders. In this study we tested the hypothesis that AFB1-induced adverse effects on gut is mediated by gut-microbiota, which is partially reflected by the changes of fecal microbiome and metabolome. F344 rats were orally exposed to AFB1 of 0, 5, 25 and 75 µg kg-1 body weight for 4 weeks and fecal samples were collected. An ion-fragmentation-spectrum-based metabolomics approach was developed to investigate the fecal microbiota-associated metabolic changes in fecal samples. We found that AFB1 inhibited the hepatic and intestinal metabolism of bile constituents. As compared to the controls, bile acid synthesis-associated cholesterols in rats treated with 25 µg kg-1 (the middle-dose group) were significantly decreased in the fecal samples, e.g., lathosterol (45% reduction), cholesterol ester (21% reduction), chenodeoxycholic acid (20% reduction), dihydroxycholesterol (55% reduction), hydroxycholesterol (20% reduction), and 5-cholestene (29% reduction). While disease-associated lipids were not detectable in the feces of the control group, they were found in AFB1-treated groups, including diglyceride, monoacylglyceride, 19,20-dihydroxy-docosapentaenoic acid, and phosphatidylethanolamine. Metabolisms of carbohydrates and production of short chain fatty acids were remarkedly decreased in all treated groups. Moreover, an inflammatory-bowel-disease (IBD)-associated taxonomic structure of fecal microbiota was observed as ∼25% Lachnospiraceae, ∼25% Ruminococcaceae, < 1% Lactobacillales, which was similar to the composition pattern found in IBD patients. These results suggest that AFB1-induced disruption on gut-microbiota, partially reflected by fecal microbiome and metabolome, may play important roles in the pathogenesis of chronic gut disorders.

Predicted Aflatoxin B1 Increase in Europe Due to Climate Change: Actions and Reactions at Global Level

Climate change (CC) is predicted to increase the risk of aflatoxin (AF) contamination in maize, as highlighted by a project supported by EFSA in 2009. We performed a comprehensive literature search using the Scopus search engine to extract peer-reviewed studies citing this study. A total of 224 papers were identified after step I filtering (187 + 37), while step II filtering identified 25 of these papers for quantitative analysis. The unselected papers (199) were categorized as "actions" because they provided a sounding board for the expected impact of CC on AFB1 contamination, without adding new data on the topic. The remaining papers were considered as "reactions" of the scientific community because they went a step further in their data and ideas. Interesting statements taken from the "reactions" could be summarized with the following keywords: Chain and multi-actor approach, intersectoral and multidisciplinary, resilience, human and animal health, and global vision. In addition, fields meriting increased research efforts were summarized as the improvement of predictive modeling; extension to different crops and geographic areas; and the impact of CC on fungi and mycotoxin co-occurrence, both in crops and their value chains, up to consumers.

The Scourge of Aflatoxins in Kenya: A 60-Year Review (1960 to 2020)

Aflatoxins are endemic in Kenya. The 2004 outbreak of acute aflatoxicosis in the country was one of the unprecedented epidemics of human aflatoxin poisoning recorded in mycotoxin history. In this study, an elaborate review was performed to synthesize Kenya’s major findings in relation to aflatoxins, their prevalence, detection, quantification, exposure assessment, prevention, and management in various matrices. Data retrieved indicate that the toxins are primarily biosynthesized by Aspergillus flavus and A. parasiticus, with the eastern part of the country reportedly more aflatoxin-prone. Aflatoxins have been reported in maize and maize products (Busaa, chan’gaa, githeri, irio, muthokoi, uji, and ugali), peanuts and its products, rice, cassava, sorghum, millet, yams, beers, dried fish, animal feeds, dairy and herbal products, and sometimes in tandem with other mycotoxins. The highest total aflatoxin concentration of 58,000 μg/kg has been reported in maize. At least 500 acute human illnesses and 200 deaths due to aflatoxins have been reported. The causes and prevalence of aflatoxins have been grossly ascribed to poor agronomic practices, low education levels, and inadequate statutory regulation and sensitization. Low diet diversity has aggravated exposure to aflatoxins in Kenya because maize as a dietetic staple is aflatoxin-prone. Detection and surveillance are only barely adequate, though some exposure assessments have been conducted. There is a need to widen diet diversity as a measure of reducing exposure due to consumption of aflatoxin-contaminated foods.

Nutrition and growth outcomes are affected by aflatoxin exposures in Kenyan children

Aflatoxin exposure, malnutrition and growth impairment in children present significant public health problems in low- and middle-income countries. Recent epidemiology studies show that exposure to aflatoxins through dietary sources in early life contributes to growth retardation among children. However, the findings remain inconclusive due to limited comparative studies in high versus low aflatoxin exposure regions. This cross-sectional study presents aflatoxin exposure levels among children aged 6 to 12 years, and further evaluates the association between aflatoxin exposure levels, malnutrition and growth impairment in Kenya, East Africa. AFB₁-lysine adducts are validated biomarkers of exposure and were quantified using HPLC with fluorescence detection. All children (n = 746) had detectable levels of AFB₁-lysine adducts in serum, range 0.65-518.9 pg/mg albumin with a geometric mean (GM) of 10.5 (95%CI 9.4-11.7) pg/mg albumin. The Geometric Means (GM) of AFB₁-lysine adducts were 14.0 (95%CI 12.5, 15.7) pg/mg albumin and 8.2 (95%CI 7.6, 8.8) pg/mg albumin (p-value < 0.001), among children recruited from Makueni and Siaya Counties, respectively. While the study confirms higher human exposure levels in Makueni county, it provides an initial data set for aflatoxin exposure levels among children recruited from Siaya County. In multivariate analysis, after adjusting for socio-economic indicators, farming practices, and household dietary patterns, increasing one unit of log AFB₁-lysine was associated with decreasing Weight-for-age z-score (WAZ) by -0.13, p-value = 0.019 among all children aged 6-12 years. Among children 6 to 9 years, WAZ decreases by -0.11 (-0.54, -0.01), p-value = 0.049. Additional growth parameters Height-for-age z-score (HAZ) and Weight-for-height z-score (WHZ) do not reach statistical significance. HAZ decreases by -0.08, p-value = 0.337 and WHZ decreases by -0.17, p-value = 0.437 with every increase in log AFB₁-lysine. These data suggest that efforts must be put in place to control for aflatoxin exposure in order to achieve better growth outcomes.

Characteristics, Occurrence, Detection and Detoxification of Aflatoxins in Foods and Feeds

Mycotoxin contamination continues to be a food safety concern globally, with the most toxic being aflatoxins. On-farm aflatoxins, during food transit or storage, directly or indirectly result in the contamination of foods, which affects the liver, immune system and reproduction after infiltration into human beings and animals. There are numerous reports on aflatoxins focusing on achieving appropriate methods for quantification, precise detection and control in order to ensure consumer safety. In 2012, the International Agency for Research on Cancer (IARC) classified aflatoxins B1, B2, G1, G2, M1 and M2 as group 1 carcinogenic substances, which are a global human health concern. Consequently, this review article addresses aflatoxin chemical properties and biosynthetic processes; aflatoxin contamination in foods and feeds; health effects in human beings and animals due to aflatoxin exposure, as well as aflatoxin detection and detoxification methods.