title: Human aflatoxicosis in developing countries: a review of toxicology, exposure, potential health consequences, and interventions.
abstract: Aflatoxins are well recognized as a cause of liver cancer, but they have additional important toxic effects. In farm and laboratory animals, chronic exposure to aflatoxins compromises immunity and interferes with protein metabolism and multiple micronutrients that are critical to health. These effects have not been widely studied in humans, but the available information indicates that at least some of the effects observed in animals also occur in humans. The prevalence and level of human exposure to aflatoxins on a global scale have been reviewed, and the resulting conclusion was that approximately 4.5 billion persons living in developing countries are chronically exposed to largely uncontrolled amounts of the toxin. A limited amount of information shows that, at least in those locations where it has been studied, the existing aflatoxin exposure results in changes in nutrition and immunity. The aflatoxin exposure and the toxic affects of aflatoxins on immunity and nutrition combine to negatively affect health factors (including HIV infection) that account for >40% of the burden of disease in developing countries where a short lifespan is prevalent. Food systems and economics render developed-country approaches to the management of aflatoxins impractical in developing-country settings, but the strategy of using food additives to protect farm animals from the toxin may also provide effective and economical new approaches to protecting human populations.
authors.affiliation: Peanut Collaborative Research Program, Griffin, GA, USA. twillia@griffin.uga.edu
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Williams
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Phillips
authors.forename: Pauline E
authors.initials: PE
authors.lastname: Jolly
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Stiles
authors.forename: Curtis M
authors.initials: CM
authors.lastname: Jolly
authors.forename: Deepak
authors.initials: D
authors.lastname: Aggarwal
mesh_terms: D000348:Aflatoxins / Q000009:adverse effects* / Q000276:immunology / Q000633:toxicity; D000818:Animals; D003906:Developing Countries; D005506:Food Contamination; D006801:Humans; D015651:Mycotoxicosis / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000348:Aflatoxins