Laura E Smith1,2, Mduduzi N N Mbuya1,2,3, Andrew J Prendergast2,3,4, Paul C Turner5, Sandra Ruboko2, Jean H Humphrey2,3, Rebecca J Nelson6, Ancikaria Chigumira7, George Kembo8, Rebecca J Stoltzfus1. 1. Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA. 2. Research Department, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe. 3. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 4. Blizard Institute, Queen Mary University of London, London, UK. 5. Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA. 6. School of Integrative Plant Sciences, Cornell University, Ithaca, NY, USA. 7. Ministry of Health and Child Care, Harare, Zimbabwe. 8. Food and Nutrition Council, Harare, Zimbabwe.
Abstract
SCOPE: Aflatoxins (AFs) are toxic secondary metabolites of Aspergillus species that contaminate staple foods such as maize and groundnuts. AF exposure during pregnancy has been associated with adverse birth outcomes in limited-scale surveys in sub-Saharan Africa. The objective of this study was to describe the determinants of AF exposure, using urinary aflatoxin M1 (AFM1) biomarkers and data generated by the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial for rural Zimbabwean women in early pregnancy. Sanitation Hygiene Infant Nutrition Efficacy is a large, cluster-randomized community-based trial in Zimbabwe designed to investigate the independent and combined effects of nutrition and hygiene interventions on early child growth. METHODS AND RESULTS: Urine samples collected from 1580 pregnant women in rural Zimbabwe at median gestational age of 13.9 wk were measured for AFM1. AFM1 was detected in 30% of samples (median of exposed, 162 pg AFM1/mg creatinine; range 30-6046 pg AFM1/mg). In multivariable ordinal logistic models, geographical location (p<0.001), seasonality (p < 0.001) and dietary practices (p = 0.011) were significant predictors of urinary AFM1. CONCLUSION: This is the largest AF biomarker survey conducted in Zimbabwe, and demonstrated frequent exposure in pregnant women with clear temporal and spatial variability in AF biomarker levels.
SCOPE: Aflatoxins (AFs) are toxic secondary metabolites of Aspergillus species that contaminate staple foods such as maize and groundnuts. AF exposure during pregnancy has been associated with adverse birth outcomes in limited-scale surveys in sub-Saharan Africa. The objective of this study was to describe the determinants of AF exposure, using urinary aflatoxin M1 (AFM1) biomarkers and data generated by the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial for rural Zimbabwean women in early pregnancy. Sanitation Hygiene Infant Nutrition Efficacy is a large, cluster-randomized community-based trial in Zimbabwe designed to investigate the independent and combined effects of nutrition and hygiene interventions on early child growth. METHODS AND RESULTS: Urine samples collected from 1580 pregnant women in rural Zimbabwe at median gestational age of 13.9 wk were measured for AFM1. AFM1 was detected in 30% of samples (median of exposed, 162 pg AFM1/mg creatinine; range 30-6046 pg AFM1/mg). In multivariable ordinal logistic models, geographical location (p<0.001), seasonality (p < 0.001) and dietary practices (p = 0.011) were significant predictors of urinary AFM1. CONCLUSION: This is the largest AF biomarker survey conducted in Zimbabwe, and demonstrated frequent exposure in pregnant women with clear temporal and spatial variability in AF biomarker levels.
Authors: Erica Phillips; Francis Ngure; Laura E Smith; Edna Makule; Paul C Turner; Rebeca Nelson; Martin Kimanya; Rebecca Stoltzfus; Neema Kassim Journal: BMC Public Health Date: 2020-05-01 Impact factor: 3.295
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