Aflatoxin Metabolites in Relation to Protein-Energy Malnutrition in Zambia
Date
2011-04-05
Authors
Samuel, Derina Sara
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Abstract
Findings in the Sudan show a possible association between
aflatoxins and kwashiorkor, a category of Protein-Energy Malnutrition
(PEM). Similarities in the geographical and seasonal prevalence
of aflatoxins and kwashiorkor, as well as similarities in the
metabolic derangements caused by aflatoxins and observed in
kwashiorkor suggest that aflatoxins may play an etiological
role in the pathogenesis of kwashiorkor.
Studies in Zambia have shown that aflatoxin contamination
occurs in commonly eaten foods, suggesting that the Zambian
population is exposed to the toxin. The presence of urinary
aflatoxins in patient with and without liver pathology at an
incidence which reflects the level of contamination has also
been reported. PEM is known to be endemic in Zambia witlva seasonal
prevalence similar to that observed with aflatoxin contamination
of food.
A one-year survey was therefore undertaken to investigate
the relationship between aflatoxins and the various categories of
PEM. Metabolism of the aflatoxins was determined by analyzing
urine and serum samples of PEM cases and appropriate controls
from the University Teaching Hospital, Lusaka. As previous studies
had shown a higher level of aflatoxin contamination in foods in
the Eastern province, urine samples from PEM cases and appropriate
controls were obtained from St. Francis1 Hospital, Katete, for
comparison.
The incidence of urinary aflatoxins in samples from Lusaka and
Katete was 6.1 per cent, with a mean concentration of 0.365 ng/ml.
Aflatoxin B, and aflatoxicol were detected. Aflatoxicol
concentrations were highest in control and lowest in kwashiorkor
samples, though aflatoxicol was detected slightly more frequently
in the latter. Aflatoxin B, excretion was observed to follow
a similar pattern. Comparing the incidences in Lusaka and Katete,
a significant difference was not observed.
In serum samples the incidence of aflatoxins was 2.8 per cent,
with a mean concentration of 1.87 ng/ml. Aflatoxin B, and
aflatoxicol were detected with aflatoxicol only being detected
in one case of kwashiorkor. Total aflatoxin concentration was
higher in kwashiorkor than controls while the incidence was
similar in the two groups.
The incidence of urinary aflatoxin in the rainy season (18.8
per cent) was greater than in the dry season (5 per cent), however,
no significant difference was observed in the seasonal variation
of aflatoxins in sera. Urinary aflatoxins were detected more
often in males than in females but no significant difference
occurred in the sera analyses.
The results suggest that there may be certain unusual
associations in the incidence, concentrations and type of aflatoxin
detected between the different nutritional groups, in particular the
role of aflatoxicol in kwashiorkor and the lower excretion levels
observed. Possibly this indicates a decreased capacity to deal
with aflatoxins. Whether this a cause or an effect of the
kwashiorkor syndrome, is still not clear. These preliminary
findings merit an extended study to examine more closely the
relationship of aflatoxins and kwashiorkor in Zambian children.
Description
Keywords
Protein Energy , Aflatoxin Metabolities