Table 2.
Summary of the studies on the association between aflatoxin exposure and child growth parameters
| Country | Study design | Study population | Aflatoxin type | Analysis technique | Detection rate | Outcome | Finding | Reference |
|---|---|---|---|---|---|---|---|---|
| Nepal | Longitudinal birth cohort | 1675 mother and infants (from pregnancy to 2 years of age follow-up) |
AFB1-lysine AFM1 |
HPLC |
1.54 pg/mg 0.04–315.99 ng/L (%94.1) |
LAZ, WAZ, WLZ z-scores, length, knee-heel length and stunting | AFB1-lysine adduct concentrations were significantly associated with changes in LAZ, length, knee-heel length and WAZ z-scores. Serum aflatoxin concentrations were associated with stunting | [49] |
| Zambia | Cross-sectional | 400 mothers with children aged 6–24 months | AFB1-lys | LC–MS/MS | NR | HAZ, WAZ and WHZ z-scores, stunting, underweight, and wasting | AFB1-lys level were found to be significantly associated with child stunting | [24] |
| Tanzania | RCT | Intervention group n = 150, control group n = 150 | Total AFs (AFB1, AFB2, AFG1 and AFG2) | HPLC | NR | WAZ z-score, dietary assessment | Mean concentration of AFs was significantly lower in the intervention than control group. Mean WAZ z-score difference between the groups was 0.57 (p < 0.05) | [50] |
| Kenya | RCT | Intervention group n = 489, control group n = 392 (mother and infants) | AFB1-lys | HPLC |
Intervention group: 2.69 pg/mL Control group: 2.74 pg/ mL |
LAZ z-score, stunting and child serum AFB1-lysine adduct | The intervention significantly reduced endline in serum AFB1-lysine adduct levels but had no effect on endline LAZ or stunting | [51] |
| Nepal | Longitudinal cohort | 85 children (15, 24, and 36 months follow-up) | AFB1-lys | UPLC | 3.62 pg/mg | LAZ, WAZ and WLZ z-scores | The chronic AF exposure was not significantly associated with anthropometric z-scores | [52] |
| Pakistan | Cross-sectional | 150 children aged 3–5 years | AFM1 | ELISA | 0.09 ± 0.32 ng/ml | HAZ, WAZ, and WHZ z-scores | A non-significant correlation was recorded between urinary AFM1 levels and the evaluated anthropometric indices | [53] |
| Tanzania | Longitudinal cohort |
143 infants (1st, 3rd and 5th months follow-up) |
AFM1 (breast milk) |
HPLC | AFM1 levels ranging from 0.01 to 0.55 ng/ml | WAZ, HAZ and WHZ z-scores | A significant association was observed between AFM1 exposure levels and WAZ or HAZ z-scores | [2] |
AF aflatoxin, HAZ height-for-age, HPLC high-performance liquid chromatography, LAZ length-for-age, LC–MS/MS liquid chromatography-mass spectrometry tandem mass spectrometry, NR not reported, UPLC ultra performance liquid chromatography, RCT randomized controlled trial, WAZ weight-for-age, WHZ weight-for-height, WLZ weight-for-length