title: A pilot study to evaluate aflatoxin exposure in a rural Ugandan population.
abstract: OBJECTIVE
  The fungal metabolite aflatoxin is a common contaminant of foodstuffs, especially when stored in damp conditions. In humans, high levels can result in acute hepatic necrosis and death, while chronic exposure is carcinogenic. We conducted a pilot study nested within an existing population cohort (the General Population Cohort), to assess exposure to aflatoxin, among people living in rural south-western Uganda.
  
  
  METHODS
  Sera from 100 adults and 96 children under 3 years of age (85 male, 111 female) were tested for aflatoxin-albumin adduct (AF-alb), using an ELISA assay. Socio-demographic and dietary data were obtained for all participants; HIV serostatus was available for 90 adults and liver function tests (LFTs) for 99.
  
  
  RESULTS
  Every adult and all but four children had detectable AF-alb adduct, including five babies reported to be exclusively breastfed. Levels ranged from 0 to 237.7 pg/mg albumin and did not differ significantly between men and women, by age or by HIV serostatus; 25% had levels above 15.1 pg/mg albumin. There was evidence of heterogeneity between villages (P = 0.003); those closest to trading centres had higher levels. Adults who consumed more Matooke (bananas) had lower levels of AF-alb adduct (P = 0.02) than adults who did not, possibly because their diet contained fewer aflatoxin-contaminated foods such as posho (made from maize). Children who consumed soya, which is not grown locally, had levels of AF-alb adduct that were almost twice as high as those who did not eat soya (P = 0.04).
  
  
  CONCLUSIONS
  Exposure to aflatoxin is ubiquitous among the rural Ugandans studied, with a significant number of people having relatively high levels. Sources of exposure need to be better understood to instigate practical and sustainable interventions.
authors.affiliation: Medical Research Council/Uganda Virus Research Institute, Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Gershim
authors.initials: G
authors.lastname: Asiki
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.forename: Chou
authors.initials: C
authors.lastname: Srey
authors.forename: Kathy
authors.initials: K
authors.lastname: Baisley
authors.forename: Tracy
authors.initials: T
authors.lastname: Lightfoot
authors.forename: Kaaya
authors.initials: K
authors.lastname: Archileo
authors.forename: Dorice
authors.initials: D
authors.lastname: Agol
authors.forename: Andrew
authors.initials: A
authors.lastname: Abaasa
authors.forename: Katie
authors.initials: K
authors.lastname: Wakeham
authors.forename: Michael N
authors.initials: MN
authors.lastname: Routledge
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Wild
authors.forename: Robert
authors.initials: R
authors.lastname: Newton
authors.forename: Yun Yun
authors.initials: YY
authors.lastname: Gong
mesh_terms: D000293:Adolescent; D000328:Adult; D000348:Aflatoxins / Q000097:blood*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins; D015415:Biomarkers / Q000097:blood; D001942:Breast Feeding; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000379:methods / Q000706:statistics & numerical data; D004781:Environmental Exposure / Q000032:analysis*; D004784:Environmental Monitoring / Q000706:statistics & numerical data*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005506:Food Contamination / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008111:Liver Function Tests / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D014454:Uganda; D055815:Young Adult
chemical_list: D000348:Aflatoxins; D000418:Albumins; D015415:Biomarkers; C098408:aflatoxin-albumin adduct
keywords: Uganda; aflatoxin; general population cohort; rural