Aflatoxin Contamination of Commercial Maize Products during an Outbreak of Acute Aflatoxicosis in Eastern and Central Kenya
By L. Lewis, M. Onsongo, H. Njapau, H. Schurz-Rogers, G. Luber, S. Kieszak, J. Nyamongo, L. Backer, A. Dahiye, A. Misore and 2 more. Environmental Health Perspectives, 2005
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In April 2004, one of the largest aflatoxicosis outbreaks occurred in rural Kenya, resulting in 317 cases and 125 deaths. Aflatoxin-contaminated homegrown maize was the source of the outbreak, but the extent of regional contamination and status of maize in commercial markets (market maize) were unknown. We conducted a cross-sectional survey to assess the extent of market maize contamination and evaluate the relationship between market maize aflatoxin and the aflatoxicosis outbreak. We surveyed 65 markets and 243 maize vendors and collected 350 maize products in the most affected districts. Fifty-five percent of maize products had aflatoxin levels greater than the Kenyan regulatory limit of 20 ppb, 35% had levels > 100 ppb, and 7% had levels > 1,000 ppb. Makueni, the district with the most aflatoxicosis case-patients, had significantly higher market maize aflatoxin than did Thika, the study district with fewest case-patients (geometric mean aflatoxin = 52.91 ppb vs. 7.52 ppb, p = 0.0004). Maize obtained from local farms in the affected area was significantly more likely to have aflatoxin levels > 20 ppb compared with maize bought from other regions of Kenya or other countries (odds ratio = 2.71; 95% confidence interval, 1.12–6.59). Contaminated homegrown maize bought from local farms in the affected area entered the distribution system, resulting in widespread aflatoxin contamination of market maize. Contaminated market maize, purchased by farmers after their homegrown supplies are exhausted, may represent a source of continued exposure to aflatoxin. Efforts to successfully interrupt exposure to aflatoxin during an outbreak must consider the potential role of the market system in sustaining exposure.
Subfields: Plant Science
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Citations in the corpus
- Mycotoxins: occurrence, toxicology, and exposure assessment. (2013, background): “This occurs sporadically in developing countries, as happened during the severe acute human aflatoxicosis outbreak in Kenya in 2004, where 317 cases and 125 deaths (39.4% mortality) were reported (Lewis et al., 2005; Probst et al., 2007).”
- How will climate change affect mycotoxins in food (2010, background): “Separating the contamination process allows improved assessment of the impact of various climatic events on contamination (Lewis et al., 2005).”
- A reappraisal of fungi producing aflatoxins (2009, background): “Acute aflatoxicosis epidemics occurred in India in 1974, resulting in 397 recognised cases and 106 deaths (Krishnamachari et al., 1975), in Kenya in 1981 (Ngindu et al., 1982) and in 2004 and 2005 causing more than 150 deaths (Azziz-Baumgartner et al., 2006; Lewis et al., 2005).”
- Incidence of aflatoxin in peanuts (Arachis hypogaea Linnaeus) from markets in Western, Nyanza and Nairobi Provinces of Kenya and related market traits (2013, background): “In Kenya, most efforts have been focused on maize, due to its significance as a staple and the chronology of acute incidences of aflatoxicosis (Lewis et al., 2005; Shephard, 2003).”
- Detoxification of aflatoxin M1 in yoghurt using probiotics and lactic acid bacteria (2014, neutral): “teratogenic, hepatotoxic and immunosuppressive properties that can cause adverse effects on animal and human health (Lewis et al., 2005).”
- Mycotoxin problem in Africa: current status, implications to food safety and health and possible management strategies. (2008, background): “The chronic incidence of aflatoxin in diets is evident from the presence of aflatoxin M1 in human breast milk in Ghana, Kenya, Nigeria, Sierra Leone, Sudan, Thailand, and the United Arab Emirates, and in umbilical cord blood samples in Ghana, Kenya, Nigeria, and Sierra Leone (Bhat and Vasanthi, 2003”
- Aflatoxin: a 50-year odyssey of mechanistic and translational toxicology. (2011, background): “In addition to the market survey for aflatoxin exposure, this outbreak marked the first time that biomarkers, namely aflatoxin-albumin adducts, were used to independently confirm the exposure in individuals (Anonymous, 2004; Azziz-Baumgartner et al., 2005; Lewis et al., 2005; Probst et al., 2007; St”