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