A Prospective Study of Growth and Biomarkers of Exposure to Aflatoxin and Fumonisin during Early Childhood in Tanzania

Candida P. Shirima, Martin E. Kimanya, Michael N. Routledge, Chou Srey, Joyce L. Kinabo, Hans-Ulrich Humpf, Christopher P. Wild, Yu-Kang Tu, and Yun Yun Gong
Publication year: 

Background: Aflatoxin and fumonisin are toxic food contaminants. Knowledge about effects of 

their exposure and co-exposure on child growth is inadequate.

Objective: To investigate the association between child growth and aflatoxin and fumonisin 

exposure in Tanzania.

Methods: A total of 166 children were recruited at 6 to 14 months of age and studied at 

recruitment, and at the sixth and twelfth month following recruitment. Blood and urine samples

were collected and analysed for plasma aflatoxin albumin adducts (AF-alb) using ELISA, and 

urinary fumonisin B1 (UFB1) using LC-MS, respectively. Anthropometric measurements were 

taken and growth index Z-scores were computed.

Results: AF-alb geometric mean concentrations (95% confidence intervals) were 4.7 (3.9, 5.6), 

12.9 (9.9, 16.7) and 23.5 (19.9, 27.7) pg/mg albumin at recruitment, six months, and 12 months 

from recruitment, respectively. At these respective sampling times, geometric mean UFB1 

concentrations (95% CI) were 313.9 (257.4, 382.9), 167.3 (135.4, 206.7) and 569.5 (464.5, 

698.2) pg/mL urine, and the prevalence of stunted children were 44%, 55% and 56%, 

respectively. UFB1 concentrations at recruitment were negatively associated with length for age 

Z-scores (LAZ) at six months (p = 0.016) and at 12 months from recruitment (p = 0.014). The 

mean UFB1 of the three sampling times (at recruitment, at six and 12 months from recruitment)

in each child was negatively associated with LAZ (p < 0.001) and length velocity (p = 0.004) at 

12 months from recruitment. The negative association between AF-alb and child growth did not 

reach statistical significance.

Conclusions: Exposure to fumonisin alone, or co-exposure with aflatoxins may contribute to 

child growth impairment.