title: Serum aflatoxin B₁-lysine adduct level in adult women from Eastern Province in Kenya depends on household socio-economic status: A cross sectional study.
abstract: BACKGROUND
  Notwithstanding the growing concern about the negative impact of aflatoxin (AF) on human health, there is a dearth of evidence on the socio-economic determinants of AF exposure in low and middle income countries.
  
  
  OBJECTIVE
  We used detailed socio-economic data to quantify to what extent socio-economic characteristics explained differences in serum AFB1-lysine adduct level in adult women from a rural area in Kenya's Eastern Province.
  
  
  METHODS
  We first explored the relationship between serum aflatoxin level and a number of household, farm, and individual characteristics using cross-sectional data on 884 mothers (pregnant or with a child under 24 months). We then used regression analyses to estimate the extent to which the combined characteristics could predict serum aflatoxin levels. We finally used the estimated regression models to predict changes in AF level when changing a women's characteristics from the most disadvantaged group (setting all socio-economic characteristics to the lowest tertile) to the most advantaged group (highest tertile).
  
  
  RESULTS
  AF was detected in all women. The median level of serum AB1-lysine adduct was 7.47 pg/mg albumin. Higher exposure levels were significantly associated with poverty: predicted serum aflatoxin levels in women living in the worst socio-economic conditions were 4.7-7.1 times higher than those with the best socio-economic status.
  
  
  CONCLUSIONS
  The results of our study, the first to show the significant association between poverty and aflatoxin exposure, highlight the need to better understand the strategies used by better-off families to mitigate AF exposure.
authors.affiliation: Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC 20006, USA. Electronic address: j.leroy@cgiar.org.
authors.forename: Jef L
authors.initials: JL
authors.lastname: Leroy
authors.affiliation: Department of Environmental Health Sciences, College of Public Health, University of Georgia, Athens, GA 30602, USA.
authors.forename: Jia-Sheng
authors.initials: JS
authors.lastname: Wang
authors.affiliation: Markets, Trade and Institutions Division, International Food Policy Research Institute, Washington, DC 20006, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Jones
mesh_terms: D000328:Adult; D016604:Aflatoxin B1 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005506:Food Contamination; D006801:Humans; D007223:Infant; D007630:Kenya; D008239:Lysine / Q000097:blood*; D018811:Maternal Exposure; D011203:Poverty; D011247:Pregnancy / Q000097:blood; D012923:Social Class; D012959:Socioeconomic Factors
chemical_list: D015415:Biomarkers; C066451:aflatoxin B1-lysine adduct; D016604:Aflatoxin B1; D008239:Lysine
keywords: Adult; Aflatoxin; Kenya; Poverty; Women