Aflatoxin: A Synthesis of the Research in Health, Agriculture and Trade

“... cases of aflatoxin
poisoning in the
East African region
have since become a
revolving epidemic...”
iMPAct of AflAtoxin in AfRicA
Aflatoxin contamination is widespread in Africa and has been studied in several
countries throughout Africa. Aflatoxin has been detected in many staple food
crops such as maize, sorghum, teff, wheat, and milk. Although east African
communities are of particular importance to the objectives of this review, the
researchers have presented data on several regions throughout Africa. Research
has been sectioned by country to maintain the integrity of reported research
findings.
c.1 iMPAct in eASt AfricA
in east Africa, there are numerous reports of fungal invasion and mycotoxic
contamination of food crops. the recurrent cases of aflatoxin poisoning in the
east African region have become a revolving epidemic, particularly in the arid
and semi-arid areas of the region. this epidemic has been attributed primarily to
crop planting and post-harvest practices. in ethiopia, aflatoxin B 1 was detected
in four crops: barley, sorghum, teff, and wheat. Retail stores and open markets
had the highest risk of crop contamination. Studies in select countries in the
east and central African regions provide evidence of cases where aflatoxin
poisoning has been observed.
kenya
Aflatoxin poisoning continues to cause widespread disease and death in
the rural areas of Kenya’s eastern and central provinces. Rates of aflatoxin
exposure and hepatitis B prevalence in rural populations are higher than rates
in urban populations, even within the high-burden developing countries. this
disparity may be explained by differences between an urban diet that is more
diverse than rural populations’ staple-based diet consisting of maize, peanuts,
and other foods prone to aflatoxin contamination. 50
Kenya has experienced several aflatoxicosis outbreaks during the last 25
years, most of which have occurred in the Makueni and Kitui districts in
eastern Province. 51 Both districts are prone to food shortages due to poor and
unreliable rainfall and high temperatures. Aflatoxin contamination of maize is
of particular global concern because maize is a widely cultivated staple food in
many countries. in Kenya alone, more than 40 percent of rural and urban diets
consist of maize and maize products. 52
the first reported outbreak of aflatoxicosis in Kenya was in 1978; other outbreaks
occurred in 1981, 2001, 2004, 2005, 2006, 2007, and 2008 that resulted in
sickness, death, and the destruction of contaminated maize stocks. 53 the largest
outbreak of 317 cases, including 125 deaths, reported in the world during the
last 20 years occurred in Kenya from January to June 2004. 54 Analyses of brain
and blood serum samples revealed that maize kernels from case households
had higher concentrations of aflatoxin than did kernels from control households.
Maize from the affected region contained as much as 4,400 ppb of aflatoxin
B 1 , which is 440 times greater than the 10 ppb tolerance level set by the Kenya
Bureau of Standards. 55
A representative survey of maize products from agricultural markets and
outlets in the Makueni, Kitui, thika, and Machakos districts was conducted
to assess the extent and magnitude of aflatoxin. Preliminary results indicated
widespread, high-level aflatoxin contamination. A total of 182 (53.2%) of 342
samples had greater than the U.S. Department of Agriculture’s (USDA) and
Who’s acceptable level of 20 parts per billion (ppb) of aflatoxin. Moreover, a
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