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Aflatoxin, kwashiorkor, and morbidity
M Adhikari1, Gita-Ramjee, P Berjak
1Department of Pediatrics and Child Health, University of Natal, Durban, South Africa.
Insights
Children with kwashiorkor exposed to aflatoxins had lower hemoglobin and longer hospital stays. Aflatoxin contamination in foods like maize increases infection risk for susceptible children.
Area of Science:
- Pediatric Nutrition
- Mycotoxicology
- Public Health
Background:
- Kwashiorkor is a severe form of malnutrition.
- Aflatoxins are toxic compounds produced by Aspergillus fungi.
- Food contamination with mycotoxins is a global health concern.
Purpose of the Study:
- To investigate the association between aflatoxin exposure and clinical outcomes in children with kwashiorkor.
- To determine if aflatoxin-positive kwashiorkor patients exhibit different clinical characteristics compared to aflatoxin-negative patients.
Main Methods:
- Children with kwashiorkor were categorized based on aflatoxin detection in serum and urine.
- Clinical records of aflatoxin-positive and -negative children were analyzed.
- Statistical comparisons were made for hemoglobin levels, edema duration, infection incidence, and hospital stay duration.
Main Results:
- Aflatoxin was detectable in 58% of the studied children.
- Aflatoxin-positive children had significantly lower hemoglobin levels (P=0.02).
- Aflatoxin-positive children experienced longer edema duration (P=0.057), more infections (P=0.037), and longer hospital stays (P=0.008).
Conclusions:
- Consumption of aflatoxin-contaminated staple foods, like maize, poses metabolic risks to children with kwashiorkor.
- Aflatoxin exposure in kwashiorkor patients is linked to poorer clinical outcomes, including increased susceptibility to infections.
- Identifying and mitigating aflatoxin contamination in food supplies is crucial for preventing severe health consequences in vulnerable populations.
Abstract:
Children suffering from kwashiorkor could be grouped as those in whom aflatoxin was detectable in both serum and urine, and those in whom this mycotoxin was undetectable. Examination of the clinical records of the aflatoxin-positive and -negative children (58% and 42% of the sample, respectively) showed several other differences between the two groups. Compared with the aflatoxin-negative group, the children scored as aflatoxin-positive showed a significantly lower haemoglobin level (P = 0.02), a longer duration of oedema (P = 0.057), an increased number of infections (P = 0.037), and a longer duration of hospital stay (P = 0.008). The present findings suggest that the consumption of a staple food such as maize that is contaminated with the fungus Aspergillus flavus exposes susceptible kwashiorkor children to the metabolic hazards of aflatoxins, resulting in a greater risk of frequent infections.