Inadequate management of complementary foods contributes to the risk of aflatoxin exposure and low nutrition status among children

Abstract

Early exposure to aflatoxins through complementary food is linked to impaired growth in childhood. The current study assessed the household’s practices on management of complementary foods in relation to the risk of aflatoxin exposure and poor nutritional status among infant and young children in Tanzania. A cross-sectional study of complementary feeding practices, aflatoxin exposure and nutritional status was conducted to 101 infants and young children aged between 6-23 months in Dodoma region of Tanzania. The intake of complementary food was estimated by using repeated 24 h dietary recall. Flour used as complementary food was sampled from each of the 101 families and aflatoxins were analysed using high-performance liquid chromatography. A deterministic approach was used to estimate dietary exposure of aflatoxins in the complementary foods. Anthropometric measurements were taken and rates of stunting, underweight and wasting estimated according to the WHO standard procedures. Multivariate logistic regression analysis was used to assess the association between feeding practices and aflatoxin exposure or the growth performance among subjects. The average consumption of complementary flour was 118 g per child per day and 52% of the flours contained groundnuts. AFB1 was detected in 42.5% of the flour and levels ranged from 0.3 to 2,128.0 μg/kg (mean 228.11±49.84 μg/kg). Dietary exposures of aflatoxin B1 ranged from 0.1 to 23,172.81 ng/kg body weight per day (mean 1,337±392.5 ng/kg). Of the subjects, 40.4% (95% CI; 29.8; 50.9) were stunted and significant association was found between stunted growth and dietary exposure of AFB1 (adjusted odd ratio (AOR)=5.9; 95% CI: 0.019-0.028). Early introduction of cereal-and groundnut-based complementary foods in Tanzania is associated with high risk of aflatoxin exposure and impaired growth in children. There is need to integrate aflatoxin management measures in the guidelines for Infant and Young Children Feeding of Tanzania.

Childhood dietary exposure of aflatoxins and fumonisins in Tanzania: A review

“…Twelve percent of the samples exceeded the Tanzanian limit (10 µg/kg) for total AFs. In another study in Dodoma region of Tanzania, Makori et al (2018) reported AFB1 contamination in 42.5% of complementary flours. The levels ranged from 0.25 to 2,128.1 µg/kg.…”

“…Maternal and caregiver unawareness about the problem of mycotoxin contamination in maize and inadequate knowledge about appropriate complementary feeding are the main reasons for the early introduction of maize-based complementary food in Tanzania. In a study conducted in Dodoma Tanzania, awareness of adequate practices for IYC feeding among parents was found to be 35% (Makori et al, 2018). Generally, extension services on child feeding are inadequate and rare.…”

“…Mothers in Tanzania use maize as the major ingredient of complementary food (Kimanya et al, 2012;Kinabo et al, 2017;Kulwa et al, 2006Kulwa et al, , 2015Makori et al, 2018). Kimanya et al (2014) estimated that maize flour consumption in complementary foods of Tanzania range from 16 to 254 g/child/day.…”

“…Almost 75% home-grown maize in Tanzania is used for human consumption at an average rate of 349 g/person/day. Additionally, mothers in Tanzania use maize as a sole or major component in complementary food (G Chen et al, 2018;Kamala et al, 2018;Kulwa et al, 2015;Makori et al, 2018;Shirima et al, 2015).…”

“…Exposure to AFs or FBs is associated with myriad health consequences including IYC growth impairment Kimanya et al, 2010Kimanya et al, , 2014Shirima et al, 2015). The main routes of AF and FB exposures are complementary foods (Kamala et al, 2015;Kimanya et al, 2008Kimanya et al, , 2014Makori et al, 2018;Shirima et al, 2015) and consumption of raw or heated cow milk (Mohammed et al, 2016;Urio et al, 2006). Reports of AF exposure through utero and breast milk in Tanzania are found in the works of Passarelli et al (2019) and Magoha et al (2014a), respectively.…”