Acute aflatoxin exposure can cause death and disease (aflatoxicosis) in humans. Aflatoxicosis fatality rates have been documented to be as high as 40% in Kenya. The inclusion in the diet of calcium silicate 100 (ACCS100), a calcium montmorillonite clay, may reduce aflatoxin bioavailability, thus potentially decreasing the risk of aflatoxicosis. We investigated the efficacy, acceptability and palatability of ACCS100 in a population in Kenya with recurring aflatoxicosis outbreaks. Healthy adult participants were enrolled in this double-blinded, crossover clinical trial in 2014. Following informed consent, participants (n = 50) were randomised to receive either ACCS100 (3 g day−1) or placebo (3 g day−1) for 7 days. Treatments were switched following a 5-day washout period. Urine samples were collected daily and assessed for urinary aflatoxin M1 (AFM1). Blood samples were collected at the beginning and end of the trial and assessed for aflatoxin B1-lysine adducts from serum albumin (AFB1-lys). AFM1 concentrations in urine were significantly reduced while taking ACCS100 compared with calcium carbonate placebo (β = 0.49, 95% confidence limit = 0.32–0.75). The 20-day interval included both the placebo and ACCS100 treatments as well as a washout period. There were no statistically significant differences in reported taste, aftertaste, appearance, colour or texture by treatment. There were no statistically significant differences in self-reported adverse events by treatment. Most participants would be willing to take ACCS100 (98%) and give it to their children (98%). ACCS100 was effective, acceptable and palatable. More work is needed to test ACCS100 among vulnerable populations and to determine if it remains effective at the levels of aflatoxin exposure that induce aflatoxicosis.
Objective: Identifying factors that may influence aflatoxin exposure in children under five years of age living in farming households in western Kenya. Design: We used a mixed methods design. The quantitative component entailed serial cross-sectional interviews in 250 farming households to examine crop processing and conservation practices, household food storage and consumption, and local understandings of aflatoxins. Qualitative data collection included focus group discussions (N=7) and key informant interviews (N=13) to explore explanations of harvesting and post-harvesting techniques and perceptions of crop spoilage. Setting: The study was carried out in Asembo, a rural community where high rates of child stunting exist. Participants: A total of 250 female primary caregivers of children under five years of age and 13 experts in farming and food management participated. Results: Study results showed that from a young age, children routinely ate maize-based dishes. Economic constraints and changing environmental patterns guided the application of sub-optimal crop practices involving early harvest, poor drying, mixing spoiled with good cereals, and storing cereals in polypropylene bags in confined quarters occupied by humans and livestock, raising risks of aflatoxin contamination. Most (80%) smallholder farmers were unaware of aflatoxins and their harmful economic and health consequences. Conclusions: Young children living in subsistence farming households may be at risk of exposure to aflatoxins and consequent ill health and stunting. Sustained efforts to increase awareness of the risks of aflatoxins and control measures among subsistence farmers could help to mitigate practices that raise exposure.
Aflatoxins are an important food safety challenge globally and in Kenya. Understanding a community’s knowledge, perception and practices is instrumental to improvement of aflatoxin control measures. Creating awareness on the causes of contamination and mitigation options could improve aflatoxin mitigation. This study aimed to map out dietary staples, establish drivers of food choices, describe knowledge and perceptions on aflatoxin and post-harvest grain management practices and use among the communities in Busia County in order to guide future evidence-based aflatoxin prevention and public health interventions. A household survey was conducted in 40 villages, and participants were selected using stratified systematic sampling in three sub-counties in rural Busia County. The survey was complemented and triangulated with a qualitative study component. Focus Group Discussions with sixty women and sixteen semi- structured interviews with nine men and seven women were conducted. Both descriptive and statistical analysis of data were performed. The results showed variability in household diversity scores and maize was observed as the community staple. While both younger and older participants were able to identify spoilt grains, they demonstrated limited knowledge and awareness of aflatoxin. Participants were not aware that seemingly clean grains could be colonized by aflatoxin as they only associated spoilage with discoloration and bitter taste of flour. Study participants were also not aware of the aflatoxin pathways to exposure as they used the spoilt grains in feeding chicken, making animal feed and local brew. Appropriate disposal methods of aflatoxin contaminated food were not known. The knowledge gap was attributed to lack of awareness creation and sensitization by the relevant government ministries. For effective control and prevention of aflatoxin contamination, farmers and traders need to be aware of the causes of aflatoxin contamination of grains, available mitigation options and health risks attributable to aflatoxin exposure in order to self-regulate. Ministries of health and agriculture, through their public health officers, community health workers and agricultural extension officers respectively need to collaborate and spearhead awareness creation among communities and institute food surveillance systems in Busia County.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.