A CASE FOR AFLATOXIN CONTROL IN NUTRITION STRATEGY

Joyceline Kaganda, Director Nutrition and Education, TFNC

INTRODUCTION Mycotoxin are secondary metabolites of moulds that exert

toxic effects on animals and humans (Mycotoxicosis)

Aflatoxins is one of the mycotoxins that frequently contaminate foods such as groundnuts, maize, rice and other cereals.

Contamination occurs if there are drought conditions during planting, and use of good agricultural practices that promote plant health is low, and when storage practice is not proper.

Perfect aflatoxin storm in sub-Saharan Africa

susceptible crops

susceptible climate

suboptimal production

systems

35o N & S

Toxic metabolites produced by Aspergillus flavus and related species in several crop species

Aflatoxin B1 is the most potent of all toxins produced by Aspergillus flavus

It is considered as carcinogen –chronic exposure can result in liver cancer

It has been associated with immune suppression and stunting

Acute exposure can lead to death

Aflatoxin B1

Aspergillus flavus: Aflatoxin producing mold

Aflatoxins

• Aflatoxins are present in blood of pregnant women exposed to aflatoxins, neonatal umbilical cord blood, and in breast milk.

• HIV/AIDS and exposure to aflatoxin forms a fatal combination because aflatoxin on its own is immunosuppressive

• Liver cancer is 30 times more likely among HBV positive populations

Aflatoxins

Aflatoxin Prevalence in TanzaniaZone N

B1

Share >LOD Mean if detected (ppb)

MaizeEastern 40 58% 37.26North 65 15% 11.03South 40 3% 1.00Southern Highlands 99 12% 4.74West 30 70% 16.51National 274 24% 20.48

GroundnutsNorth 20 30% 14.42South 40 33% 11.80West 40 35% 10.72National 100 33% 11.82

LOD = Limit of Detection; ppb = Parts per Billion

Prevalence of Aflatoxin B1 in Groundnuts

Prevalence of Aflatoxin B1 in Maize

Health –Risk of Aflatoxin ExposureShare of Foods in Weekly Calorie

Intake of Households

• Maize constitutes a large share of Tanzanian diets.

• There is heavy reliance on maize-based porridges during a child’s weaning stage.

• Consumers’ level of aflatoxin knowledge is very low.

• A large share of maize consumption comes from own production for agricultural households

Sensitivity Analysis of Impacts

 Zone

 Maize and GroundnutConsumption (g/person(60kg)/day)

Aflatoxin Contamination (ppb)1 4 10 20 50 100

Central 367 9 36 90 181 452 903

Eastern 261 11 46 115 230 575 1,150

Lake 278 15 60 149 298 746 1,491

North 362 17 68 171 342 854 1,708

South 299 8 32 81 162 406 812

Southern Highlands

495 20 81 203 406 1,015 2,030

West 508 28 111 277 554 1,385 2,770

Zanzibar 66 1 2 6 11 28 55

National 521 109 437 1,092 2,184 5,460 10,920

Estimated the impact with varying contamination.Even at 10 ppb the current consumption levels of maize implies that 1092 out of 1209 liver cancer cases can be attributed to aflatoxins.

In another sensitivity analysis, we estimate that if HBV prevalence is reduced to zero, the total number of liver cancer cases attributed to aflatoxins would reduce 3-fold

Tanzania Aflatoxin Stakeholders’ Workshop3-4 December 2012• Over 50 participants from government, private sector, and

NGOs, and from agriculture, health, and trade sectors in Tanzania. 

• Participants agreed to form a National Forum on Mycotoxins Control.

• Participants also agreed to form a National Steering Committee on Mycotoxins Control.  TFDA will serve as secretariat.

• Attendees identified priority activities and strategies in pre-harvest, post-harvest, public health, trade, and policy.

• The new Steering Committee plans to meet in January 2013 to discuss next steps and make further plans.

Priority Public Health Strategies to Control Aflatoxin1. Work with representatives from the agriculture and

trade sectors to develop public awareness campaigns about the aflatoxins problem and how to reduce aflatoxins.

2. Promote food handling, processing, and preparation activities that can reduce aflatoxin.

3. Implement programs to detect and map aflatoxin in cereals at the community level.

4. Conduct additional alfatoxin research.5. HBV vaccination

Priority Policy Strategies to Control Aflatoxin

1. Recommend finalization of policies, taking into account food safety and mycotoxins:

• National Food Security Policy• Draft Regulations under Grazing Lands and Animal Feed

Resources Act• National Nutrition Policy

2. Include line item for mycotoxins control in upcoming budget.

Priority Policy Strategies to Control Aflatoxin (continued)

3. Raise awareness of aflatoxin among policy makers.4. Recommend routine monitoring of mycotoxins in

cereal-based weaning foods.5. Include reference to myctoxins in Infant and Young

Child Nutrition Guidelines.6. Develop guidelines and other IC materials for

controlling mycotoxins in agricultural production.