title: A prospective study of growth and biomarkers of exposure to aflatoxin and fumonisin during early childhood in Tanzania.
abstract: BACKGROUND
  Aflatoxin and fumonisin are toxic food contaminants. Knowledge about effects of their exposure and coexposure on child growth is inadequate.
  
  
  OBJECTIVE
  We investigated the association between child growth and aflatoxin and fumonisin exposure in Tanzania.
  
  
  METHODS
  A total of 166 children were recruited at 6-14 months of age and studied at recruitment, and at the 6th and 12th month following recruitment. Blood and urine samples were collected and analyzed for plasma aflatoxin-albumin adducts (AF-alb) using ELISA, and urinary fumonisin B1 (UFB1) using liquid chromatography-mass spectrometry, respectively. Anthropometric measurements were taken, and growth index z-scores were computed.
  
  
  RESULTS
  AF-alb geometric mean concentrations (95% CIs) 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, 6 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 was 44%, 55%, and 56%, respectively. UFB1 concentrations at recruitment were negatively associated with length-for-age z-scores (LAZ) at 6 months (p = 0.016) and at 12 months from recruitment (p = 0.014). The mean UFB1 of the three sampling times (at recruitment and at 6 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 coexposure with aflatoxins may contribute to child growth impairment.
authors.affiliation: Division of Epidemiology, School of Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Candida P
authors.initials: CP
authors.lastname: Shirima
authors.forename: Martin E
authors.initials: ME
authors.lastname: Kimanya
authors.forename: Michael N
authors.initials: MN
authors.lastname: Routledge
authors.forename: Chou
authors.initials: C
authors.lastname: Srey
authors.forename: Joyce L
authors.initials: JL
authors.lastname: Kinabo
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Humpf
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Wild
authors.forename: Yu-Kang
authors.initials: YK
authors.lastname: Tu
authors.forename: Yun Yun
authors.initials: YY
authors.lastname: Gong
mesh_terms: D000348:Aflatoxins / Q000097:blood / Q000378:metabolism* / Q000652:urine; D000418:Albumins; D015415:Biomarkers / Q000097:blood / Q000652:urine; D049628:Body Size; D002657:Child Development; D002853:Chromatography, Liquid; D004781:Environmental Exposure / Q000032:analysis* / Q000706:statistics & numerical data; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005506:Food Contamination; D037341:Fumonisins / Q000378:metabolism* / Q000652:urine; D006130:Growth Disorders / Q000139:chemically induced; D006801:Humans; D007223:Infant; D008297:Male; D013058:Mass Spectrometry; D011446:Prospective Studies; D013636:Tanzania
chemical_list: D000348:Aflatoxins; D000418:Albumins; D015415:Biomarkers; D037341:Fumonisins; C098408:aflatoxin-albumin adduct; C056933:fumonisin B1