Abstract
Evidence about the magnitude of the aflatoxin menace can help policy makers appreciate the importance of the problem and strengthen policies to support aflatoxin mitigation measures. In this study, we estimated aflatoxin-induced liver cancer risk in 2016 for Tanzania and used the information to estimate the health burden due to the aflatoxin exposure in the country. The burden of aflatoxin-induced liver cancer was assessed based on available aflatoxin biomarker data from a previous epidemiology study, hepatitis B virus infection prevalence and population size of Tanzania in 2016. The health burden due to aflatoxin-induced liver cancer was estimated using disability adjusted life years (DALYs). The aflatoxin exposures ranged from 15.0–10,926.0 ng/kg bw/day (median, 105.5 ng/kg bw/day). We estimated that in 2016 there were about 1,480 (2.95 per 100,000 persons) new cases of aflatoxin-induced liver cancer in Tanzania and assumed all of them would die within a year. These morbidity and mortality rates led to a total loss of about 56,247.63 DALYs. These results show, quantitatively, the cases of liver cancer and related deaths that could be avoided, and the healthy life years that could be saved, annually, by strengthening measures to control aflatoxin contamination in Tanzania.
Highlights
Aflatoxins are fungal metabolites, primarily produced by Aspergillus, mainly A. flavus and A. parasiticus, in foods such as maize, groundnuts, tree nuts and spices, and which have impacted human health for many years
There are four types of aflatoxin that are important in health and agriculture: aflatoxin B1 (AFB1), B2 (AFB2), G1 (AFG1) and G2 (AFG2)
The risks estimated for Iringa, Kilimanjaro, Tabora and Tanzania are similar to risks recently reported for Borgou (7.4) in Benin or Kano (1.4) in Nigeria or Bamako (2.0) in Mali [27]
Summary
Aflatoxins are fungal metabolites, primarily produced by Aspergillus, mainly A. flavus and A. parasiticus, in foods such as maize, groundnuts, tree nuts and spices, and which have impacted human health for many years. There are four types of aflatoxin that are important in health and agriculture: aflatoxin B1 (AFB1), B2 (AFB2), G1 (AFG1) and G2 (AFG2). AFB1 is the most common and most toxic of the four types. Intake of high doses of aflatoxins can cause acute aflatoxicosis whereas intake of low to moderate doses over a long period can result in immune suppression, impaired growth, low birth weight and liver cancer [1,2,3].
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