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Aflatoxin and outcome from acute lower respiratory infection in children in The Philippines

D W Denning1, S C Quiepo, D G Altman

  • 1Lister Unit, Northwick Park Hospital, Harrow, UK.

Annals of Tropical Paediatrics
|September 1, 1995
PubMed

Insights

Aflatoxin exposure in children with pneumonia was common. Undetectable serum aflatoxin, possibly due to anorexia, was linked to death, while detectable levels were not associated with mortality in this Philippine study.

Area of Science:

  • Environmental Health
  • Pediatrics
  • Toxicology

Background:

  • Aflatoxins are known immunosuppressants in experimental settings.
  • Poor outcomes in childhood acute lower respiratory infections (ALRI) are a significant global health concern.
  • The Philippines experiences a high burden of ALRI in children, necessitating investigation into contributing factors.

Purpose of the Study:

  • To investigate the potential role of aflatoxin exposure in the poor outcomes of pediatric ALRI in the Philippines.
  • To assess the correlation between aflatoxin levels (recent and chronic exposure) and ALRI severity and mortality.
  • To explore potential mechanisms linking aflatoxin exposure to adverse health outcomes in children.

Main Methods:

  • Serum and urine samples were collected from 115 children presenting with ALRI in the Philippines.
  • Aflatoxins in serum (recent ingestion) and urinary aflatoxin metabolites (chronic ingestion) were quantified using ELISA.
  • ALRI severity was assessed using WHO criteria, and outcomes included mortality, fever duration, and consciousness level.

Main Results:

  • Aflatoxin exposure was widespread, with serum aflatoxin detected in 33% and urinary metabolites in 64/65 children.
  • None of the children with detectable serum aflatoxin died; undetectable serum aflatoxin was strongly associated with death (p=0.004).
  • No significant relationship was found between urinary aflatoxin metabolite concentrations and ALRI outcomes.

Conclusions:

  • While widespread aflatoxin exposure was evident, its direct causal role in ALRI mortality remains unclear.
  • The association between undetectable serum aflatoxin and death may indicate severe illness leading to anorexia.
  • Further research is warranted to elucidate the complex interplay between aflatoxin, immunosuppression, and pediatric respiratory infections.

Keywords:
Appetite AlterationsAsiaBiologyCentral Nervous SystemCentral Nervous System EffectsChild MortalityClinical ResearchDemographic FactorsDeveloping CountriesDiseasesEnvironmentFood SupplyImmunityImmunological EffectsInfectionsMortalityNatural ResourcesPhilippinesPhysiologyPopulationPopulation DynamicsResearch MethodologyResearch ReportRespiratory InfectionsSigns And SymptomsSoutheastern Asia

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