Dietary aflatoxin exposure and impaired growth in young children from Benin and Togo: cross sectional study
Gong, Y.Y.; Cardwell, K.; Hounsa, A.; Egal, S.; Turner, P.C.; Hall, A.J.; Wild, C.P.
BMJ 325(7354): 20-21
2002
ISSN/ISBN: 0959-8138 PMID: 12098724 DOI: 10.1136/bmj.325.7354.20Document Number: 242387
A study was conducted to assess aflatoxin exposure in relation to anthropometric measurements in children in Benin and Togo. A total of 480 children, aged nine months to five years, from 16 villages in four geographical zones were enrolled in the study. Aflatoxin-albumin adducts were detected in 475 of 479 (99%) samples (one sample missing). Aflatoxin-albumin concentration increased with age up to three years, after which it reached a plateau. In 302 children aged three years and below, the mean concentration was 2.5-fold higher in fully weaned children (45.6 pg/mg) than in those still partially breastfed. In a multivariate model adjusting for age, sex, socioeconomic status and agri-ecological zone, weaning status was significantly associated with aflatoxin-albumin concentration (P=0.0001). Prevalence of malnutrition was 33% for stunting (height for age z score <=2), 29% for being underweight (weight for age z score <=2) and 6% for wasting (weight for height z score <=2). Children with stunting or who were underweight had 30-40% higher mean aflatoxin-albumin concentrations. After similar adjustments, the negative correlation between individual aflatoxin-albumin concentration and each of the three growth parameters was highly significant (P=0.0001 for height for age, P=0.005 for weight for age and P=0.047 for weight for height). The association with aflatoxin-albumin concentration was again significant, with clear dose-response relations with height for age and weight for age z scores.