Safety and Quality Assessment of Smallholder Farmers' Maize in the Western Highlands of Guatemala

Dietary, socioeconomic, and maize handling practices associated with aflatoxin and fumonisin exposure among women tortilla makers in 5 departments in Guatemala

Previous research has demonstrated human exposure to mycotoxins among Guatemalans, with high levels of mycotoxins being found in blood and urine samples as well as in maize for human consumption. Mishandling of crops such as maize during pre- and post-harvest has been associated with mycotoxin contamination. The overarching goal of this study was to identify risk factors for aflatoxin and fumonisin exposure in Guatemala. A cross-sectional survey of 141 women tortilla makers was conducted in the departments of Guatemala, Sololá, Suchitepéquez, Izabal, and Zacapa in February 2022. Maize and tortilla samples were collected and analyzed for aflatoxin B1 (AFB1) and fumonisin B1, B2, and B3 contamination (FB1, FB2, FB3). Urine samples were collected and analyzed for urinary FB1 (uFB1) contamination. A questionnaire was administered to collect data on sociodemographic characteristics, dietary intake of maize-based foods the week prior to the study, and maize handling practices. Descriptive statistics were used to describe common maize handling practices. A univariable analysis was conducted to identify predictors of low/high AFB1, total fumonisins, and uFB1. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). During tortilla processing, a reduction in the AFB1 and total fumonisin levels was observed. The presence of AFB1 in maize was associated with department and mean total fumonisin level in maize (OR: 1.705, 95% CI: 1.113-2.613). The department where the tortilleria was located was significantly associated with the presence of fumonisins in tortillas. Increased consumption of Tortrix was significantly associated with the presence of FB1 in urine (OR: 1.652, 95% CI: 1.072-2.546). Results of this study can be used in the development and implementation of supply chain management practices that mitigate mycotoxin production, reduce food waste and economic loss, and promote food security.

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.

Assessment of aflatoxin exposure, growth faltering and the gut microbiome among children in rural Guatemala: protocol for an observational prospective cohort and bioreactor simulations

INTRODUCTION

Aflatoxin B1 (AFB1) is a carcinogen produced by Aspergillus flavus and Aspergillus parasiticus which grow on maize. Given the high prevalence of child stunting (ie, impaired growth) and other nutritional disorders in low-income and middle-income countries, where maize is consumed, the role of aflatoxin exposure may be significant. Observational reports have demonstrated associations between aflatoxin exposure and impaired child growth; however, most have been cross-sectional and have not assessed seasonal variations in aflatoxin, food preparation and dynamic changes in growth. Biological mechanistic data on how aflatoxin may exert an impact on child growth is missing. This study incorporates a prospective cohort of children from rural Guatemala to assess (1) temporal associations between aflatoxin exposure and child growth and (2) possible mediation of the gut microbiome among aflatoxin exposure, inflammation and child growth.

METHODS AND ANALYSIS

We will prospectively evaluate aflatoxin exposure and height-for-age difference trajectories for 18 months in a cohort of 185 children aged 6-9 months at enrolment. We will assess aflatoxin exposure levels and biomarkers of gut and systemic inflammation. We will examine the faecal microbiome of each child and identify key species and metabolic pathways for differing AFB1 exposure levels and child growth trajectories. In parallel, we will use bioreactors, inoculated with faeces, to investigate the response of the gut microbiome to varying levels of AFB1 exposure. We will monitor key microbial metabolites and AFB1 biotransformation products to study nutrient metabolism and the impact of the gut microbiome on aflatoxin detoxification/metabolism. Finally, we will use path analysis to summarise the effect of aflatoxin exposure and the gut microbiome on child growth.

ETHICS AND DISSEMINATION

Ethics approval was obtained from Arizona State University Institutional Review Board (IRB; STUDY00016799) and Wuqu' Kawoq/Maya Health Alliance IRB (WK-2022-003). Findings will be disseminated in scientific presentations and peer-reviewed publications.

Effects of Storage Duration and Structures on Sesame Seed Germination, Mold Growth, and Mycotoxin Accumulation

Sesame is an important oil crop for the Ethiopian economy. However, the lack of adequate storage facilities results in significant losses of sesame seeds. This study was designed to compare the effects of storage conditions and the subsequent impact on sesame seed germination, mold growth, and mycotoxin accumulation over the storage period. The efficacy of two hermetic bags (1. Purdue Improved Crop Storage (PICS) bags and 2. Super GrainPro (SGP) bags) was directly compared to sesame storage in polypropylene (PP bags) and Jute bags. Storage conditions (oxygen, carbon dioxide, temperature, moisture content and relative humidity) of samples were analyzed in the laboratory in three replicates. Results showed that the oxygen concentrations dropped to 6.9% (±0.02) in PICS bags and 8.7% (±0.06) in SGP bags at the end of 6 months of storage. In non-hermetic bags Jute and PP), oxygen levels were close to atmospheric levels at 2-, 4-, and 6-month storage periods. In non-hermetic bags throughout storage, the amount of seed infection by mold constantly increased, and seed germination decreased. Sesame seeds stored in hermetic bags had 89.7% (±0.58) to 88.3% (±2.89) germination rates versus 61.67% (±2.08) for non-hermetic storage bags over the 6-month seed storage period. All mycotoxin levels increased over the same storage period, whereas comparative levels were much lower in hermetic bags after six months. Sesame seeds stored in both hermetic bags had the lowest level of tested mycotoxins, and levels among the SGP and PICS bags were not significantly different from one another. This study provides strong evidence indicating that hermetic storage structures such as PICS and SGP significantly affect temperature, humidity, moisture content, CO2 and oxygen levels resulting in the lowering of fungal growth and mycotoxin accumulation and effectively preserving stored sesame without relying on synthetic pesticides in Ethiopia.

Dietary and socioeconomic risk factors for fumonisin exposure among women of reproductive age in 18 municipalities in Guatemala from 2013 to 2014

Fumonisin exposure is common in populations where maize is a dietary staple, such as in Guatemala, and has been associated with negative health outcomes including neural tube defects. The objective of this study was to estimate fumonisin B1 (FB1) exposure among Guatemalan reproductive-age women and develop a better understanding of the dietary and sociodemographic risk factors for exposure. A cross-sectional study in 18 municipalities in Guatemala was conducted. Midwives and study nurses enrolled consenting women and collected individual and household demographic and socioeconomic data. A food frequency questionnaire was administered to estimate quantity and types of food products consumed. A urine sample was collected and urinary fumonisin B1 (uFB1) concentration was measured. A univariable analysis was conducted to identify predictors of low/high uFB1. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). In total, 775 women had analyzable urine samples. Higher uFB1 levels were associated with speaking Mayan (OR = 2.33, 95% CI:1.44-3.77), less than high school education (OR = 1.61, 95% CI:1.12-2.30), increasing dietary proportion of maize-based foods (OR = 1.02, 95% CI:1.01-1.03), and consumption of tostadas (fried tortillas) (OR = 1.11, 95% CI:1.02-1.22). Lower uFB1 levels were associated with consumption of highly processed maize-based foods (OR = 0.93, 95% CI:0.87-0.99). Tortillas were the most frequently consumed maize-based food among study participants and significantly associated with high uFB1 exposure in the univariable but not multivariable analysis. Consumption of >4,750 grams/week of maize-based foods, >5,184 g/week of locally produced maize-based foods, and >110 servings/week of tortillas were also significantly associated with high uFB1 exposure in univariable analysis. Populations with low socioeconomic status/education levels and high consumption of maize-based foods had higher fumonisin exposure. Interventions aimed at reducing the risk of exposure to mycotoxins through maize in Guatemala, including the increased consumption of non-maize-based foods, should be further explored.

Evaluation of the impact of pre- and post-harvest maize handling practices on mycotoxin contamination on smallholder farms in Guatemala

Mycotoxins are secondary metabolites produced by fungi including Aspergillus and Fusarium that commonly contaminate crops, such as maize, resulting in economic losses and food insecurity. Mycotoxins can contaminate crops during pre- and post-harvest stages. Consumption of mycotoxin-contaminated foods has been linked to a variety of negative health outcomes including liver cancer, stunting, and neural tube defects. In countries such as Guatemala where maize constitutes a major portion of the diet, mycotoxins can be a significant contributor to disease burden. This review describes maize pre- and post-harvest practices in Guatemala that can lead to the development of mycotoxins and subsequent exposure to humans and animals, current information gaps, and opportunities for future research. There are specific challenges to minimising fungal growth and subsequent mycotoxin production during storage of maize in Guatemala, including reducing moisture content, minimising pest damage, and controlling temperature. Research on maize-handling practices that are associated with the greatest mycotoxin exposure in Guatemala is needed to prioritise allocation of resources and reduce exposure.

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.

The influence of local market and household factors on aflatoxin presence in maize and symptoms of its exposure to children in Guatemala

Recent evidence supports the hypothesis that aflatoxin exposure from maize can influence malnutrition rates among children. Therefore, in Guatemala we investigated two questions; which maize sources exposed households to higher risk of aflatoxin exposure symptoms and what the risk factors were for each maize source, pre- and post-maize harvest. Survey data and household maize samples were collected in October 2016 (pre-harvest) and February 2017 (post-harvest) in San Vicente, Guatemala. Structural equation modeling (SEM) and odds ratios were used to assess the data. The results suggested that households which purchased maize from the market had 3.64 higher odds of high levels of aflatoxin. The models identified that good market purchase habits were significant for market-based maize sources while improved post-harvest practices and improved types of maize storage were significant for subsistence-based maize sources. Cumulative results suggest multiple interventions may be effective but are dependent on time of year and source of maize.

Association between aflatoxin-albumin adduct levels and tortilla consumption in Guatemalan adults

Aflatoxin B₁ (AFB₁) is a known human hepatocarcinogen and a recent study reported elevated AFB₁ levels, measured by serum albumin biomarkers, among Guatemalan adults. While AFB₁ can contaminate a variety of foodstuffs, including maize, Guatemala's main dietary staple, the relationship of maize intake to serum AFB₁-albumin adducts levels in Guatemala has not been previously examined. As a result, a cross-sectional study was conducted among 461 Guatemalan adults living in five geographically distinct departments of the country. Participants provided a serum sample and completed a semi-quantitative food frequency questionnaire and a sociodemographic questionnaire. Multiple linear regression analysis was used to estimate the least square means (LSQ) and 95% confidence intervals (95% CI) of log-transformed AFB₁-albumin adducts by quintiles of maize consumption in crude and adjusted models. Additionally, analyses of tortilla consumption and levels of maize processing were conducted. The median maize intake was 344.3 g per day [Interquartile Range (IQR): 252.2, 500.8], and the median serum AFB₁-albumin adduct level was 8.4 pg/mg albumin (IQR: 3.8, 22.3). In adjusted analyses, there was no association between overall maize consumption and serum AFB₁-albumin levels. However, there was a statistically significant association between tortilla consumption and AFB₁-albumin levels (p_trend = 0.01). The LSM of AFB₁-albumin was higher in the highest quintile of tortilla consumption compared to the lowest quintile [LSM:9.03 95%CI: 7.03,11.70 vs 6.23, 95%CI: 4.95,8.17, respectively]. These findings indicate that tortilla may be an important source of AFB₁ exposure in the Guatemalan population. Therefore, efforts to control or mitigate AFB₁ levels in contaminated maize used for tortillas may reduce overall exposure in this population.

Evaluation of emerging biomarkers of renal damage and exposure to aflatoxin-B1 in Mexican indigenous women: a pilot study

Aflatoxins (AFs) are mycotoxins produced by Aspergillus parasiticus and Aspergillus flavus which frequently contaminate maize. These compounds are considered toxic, especially AFB1 which has been classified as a human carcinogen, due to its relationship with the generation of hepatocellular carcinoma. Studies in vivo, in animal models, prove that chronic consumption of AFB1 has an association with renal adverse effects, but evidence in humans is scarce. Therefore, the main objective of this research was to conduct a pilot study to evaluate the correlation between exposure to AFB1 and early-stage renal damage in indigenous women of San Luis Potosí, Mexico. Exposure to AFB1 was measured through the biomarker AFB1-lysine and renal damage through kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin-C (Cys-C). AFB1-Lys was measured by HPLC-FLD. The method was validated with a correlation coefficient of 0.99 and limit of detection and quantification of 3.5 and 4.7 pg mL-1, respectively. Levels of NGAL, KIM-1, and Cys-C were determined (median (P25-P75), 5.96 (3.16-15.91), 0.137 (0.137-0.281), and 18.49 (5.76-29.57) ng mL-1, respectively). Additionally, glomerular filtration rate (GFR) (83.3 (59.8-107.4) mL/min/1.73 m2) and serum creatinine (SCr) (0.88 (0.72-1.22) mg dL-1) were obtained. The median concentrations for AFB1-Lys were 2.08 (1.89-5.8) pg mg-1 of albumin. Statistically significant correlations between AFB1-Lys/KIM-1 (Rho = 0.498, p = 0.007) and AFB1/Cys-C (Rho = 0.431, p = 0.014) were found. Our results indicate that women are exposed to AFB1, due to the fact that the AFB1-Lys biomarker was found in a high percentage of the study population (83%). In addition, the results of exposure to AFB1 show a strong significant correlation between KIM-1 and Cys-C that may indicate the toxic renal effect. These results are alarming because of the high toxicity of this compound and require adequate intervention to reduce AFB1 exposure in these populations.

Pre-harvest management is a critical practice for minimizing aflatoxin contamination of maize

Maize, the main dietary staple in Kenya, is one of the crops most susceptible to contamination by aflatoxin. To understand sources of aflatoxin contamination for home grown maize, we collected 789 maize samples from smallholder farmers' fields in Eastern and South Western, two regions in Kenya representing high and low aflatoxin risk areas, respectively, and determined aflatoxin B1 (AFB1) using ELISA with specific polyclonal antibodies. AFB1 was detected in 274 of the 416 samples from Eastern Kenya at levels between 0.01 and 9091.8 μg kg-1 (mean 67.8 μg kg-1). In South Western, AFB1 was detected in 233 of the 373 samples at levels between 0.98 and 722.2 μg kg-1 (mean 22.3 μg kg-1). Of the samples containing AFB1, 153 (55.8%) from Eastern and 102 (43.8%) from South Western exceeded the maximum allowable limit of AFB1 (5 μg kg-1) in maize for human consumption in Kenya. The probable daily intake (PDI) of AFB1 in Eastern Kenya ranged from 0.07 to 60612 ng kg-1 bw day-1 (mean 451.8 ng kg-1 bw day-1), while for South Western, PDI ranged from 6.53 to 4814.7 ng kg-1 bw day-1 (mean 148.4 ng kg-1 bw day-1). The average PDI for both regions exceeded the estimated provisional maximum tolerable daily intake of AFB1, which is a health concern for the population in these regions. These results revealed significant levels of preharvest aflatoxin contamination of maize in both regions. Prevention of preharvest infection of maize by toxigenic A. flavus strains should be a critical focal point to prevent aflatoxin contamination and exposure.