OCCURRENCE AND RISKS OF AFLATOXINS AND FUMONISINS IN LOCALLY PROCESSED BABY PORRIDGE FLOUR IN MALAWI

Abstract

Infants, once introduced to supplementary feeding, are at a high risk of exposure to mycotoxins such as aflatoxins and fumonisins. The aim of this study was to examine the occurrence and risks associated with aflatoxins and fumonisins in local baby porridge flour in Malawi. A structured questionnaire was administered to 338 households from 13 districts in Malawi to gather child anthropometric data as well as knowledge, attitude and practices (KAP) of caregivers. From each household, porridge flour samples were collected and analyzed for aflatoxin and fumonisin. A supplementary consumption study involving sixty 6-24 months old children was conducted to estimate maize flour intake. The risk of exposure to aflatoxins and fumonisins was estimated using the probabilistic Monte Carlo approach. Subsequently, the risk of aflatoxin induced Hepatocellular Carcinoma (HCC) was estimated. The average knowledge score for the caregivers was 7.024±1.871 out of 30 points and there was no association between the score and caregivers’ education attainment. The average practice score was at 4.18±0.12 out of a possible 5 points. About 22% and 27% of the children were moderately and severely stunted respectively. Except for child’s gender, age and education level of the caregiver, stunting had a direct significant (p < 0.05) association with, mycotoxin exposure, socio-economic status as well as residence in the southern region. There were significant differences (p < 0.05) in the occurrence and levels of aflatoxins and fumonisins amongst the districts. Aflatoxins were detected in 59 % of the total samples with lower levels in Dedza (mean, x̅ = 3.4µg/kg) and highest in Balaka (x̅ = 43.8µg/kg). Fumonisins were detected in 96% of the samples with the lower levels found in Nsanje (x̅ = 884.6µg/kg) and higher levels in Balaka (x̅ = 2842.3µg/kg). Aflatoxin and fumonisin co-occurred in 57% of the samples and only about 2% of the total samples complied with the EU limits for both aflatoxins (4µgkg) and fumonisins (200µg/kg). About 90% of the study population was concurrently exposed to aflatoxin and fumonisin levels beyond reference toxicological values with a risk of dietary aflatoxin-induced liver cancer estimated between 3.19 and 3.27 per 100,000 population.