The Role of Mycotoxin Contamination on Nutrition: The Aflatoxin Story Amare Ayalew, Program Manager, Partnership for Aflatoxin Control in Africa (PACA), Ethiopia

1. The Role of Mycotoxin
Contamination in
Nutrition: The Aflatoxin
Story
Amare Ayalew (PACA), Vivian Hoffmann (IFPRI),
Chibundu N. Ezekiel (PACA), and Jahanna Lindhal
(ILRI)

2. Objectives:
• Highlight the linkage between food safety and
nutrition security and economic development
• Highlight mycotoxins as a major food safety
challenge
• Describe nutrition and health and economic
implications of aflatoxins; the extent of
contamination and sources of exposure
• Describe contribution of mycotoxin control to
major developmental agenda
• Highlight options for aflatoxin management and
outline action areas

3. Globally accepted definition of
food security
expressly links
nutrition and food safety:
• Food security exists when all people, at all
times, have physical access to sufficient,
safe and nutritious food which meets their
dietary needs and food preferences for an
active and healthy life.

4. Unfulfilled linkages
between food security,
nutrition and food
safety
• Disproportionate focus on supply, with emphasis
on food production and stock availability
• Over the last decade, the necessity to embed
nutrition into agriculture is well recognized
• Unsafe, contaminated foods stilll thwart food
security and nutrition

5. Food safety impacts food security
and nutrition and development
• Unsafe food is not food – contaminated food
could cause disease, immune suppression and
stunting
• When contaminated crop is withdrawn from the
supply chain the quantum of food is directly
impacted
• Food contamination affects access to markets
and rural incomes, and thus access to food but
also economic well-being

6. Mycotoxin contamination is a
major food safety challenge
 Mycotoxins are toxic compounds, harmful to human and
animal health, that are produced by some fungi
 Contamination of food with mycotoxins is a prominent
food safety challenge in tropical regions.
 In Africa, aflatoxins and fumonisins are the most
important mycotoxins
 Aflatoxins receive priority attention due to:
• high pre- and postharvest contamination potential
• widespread occurrence in diverse foods and animal
feeds
• extreme toxicological significance to humans and
animals,
• impacts on food safety, nutrition, public health, and
markets and income

7. Aflatoxins impact on
three sectors (most
pervasive food safety challenge
in Africa)
Public
health
Food and
nutrition
security
Trade
and
economy

8. Nutrition and Health
Implications of Aflatoxins
• Acute effects which are often fatal
• Chronic effects:
• Liver cancer:
• 40% of global liver cancer cases occur in Africa
• Aflatoxin contributes to upto 30% of the liver cancer cases
• Immunosuppression aggravating HIV, malaria
• Childhood growth faltering (underweight and
stunting and reduced cognitive development):
• interfering with absorption and metabolism of vitamins and
minerals, protein malnutrition, gastrointestinal toxicity

9. Nutrition and Health Implications
of Aflatoxins: Exposure Sources
• First 1000 Days
• During pregnancy
• During breastfeeding
• via the introduction of complementary weaning
foods
• Throughout the life of an individual:
• Through consumption of contaminated foods
• Particularly susceptible foods include maize,
groundnut, sorghum, tree nuts and processed
cassava
• Occupational exposure: grain dust

10. Aflatoxin exposure in
1,000 days of life:
Complementary/weaning foods
(450 – 1000 days; AFB1, AFG1 & AFM1)
Trans-placental
exposure
(0 – 270 days; AFB1)
Breastmilk
(270 – 450 days; AFM1)
Maternal exposure
Nutrition: consumption of aflatoxin contaminated foods
Cow milk and
other milk-
based products
Cereal, tubers
and nut-based
foods
Premature introduction
(360 – 450 days)
Neonatal
and infant
exposure
- Low birth weight
- Impaired growth
- Cognitive development
- Impaired immune function
- Impaired GIT function
- Stunting

11. Economic Impacts of Aflatoxins
• Loss from mortality and morbidity
• Export markets
• aflatoxins need to be managed if the continent is to
reclaim a share in global groundnut trade and many
other agricultural commodities
• Smallholder market access
• Aflatoxin is major part of quality and safety requirements
of premium buyers
• Smallholder farmers unable to comply with food safety
standards denied opportunity for income growth
• Livestock productivity (no estimates of economic
consequences in livestock subsector in Africa)
• impacts on livestock weight gain and productivity;
mortality; contamination of milk, egg and meat
• Susceptibility: pigs> turkeys>chicken>cattle

12. Prevalence of Aflatoxins in Major
Food Supply Chains
• East and West African regions as well as North Africa exhibit
both the highest rates of contamination and levels of the toxin
• In a wide range of foodstuffs, the most severely contaminated
crops are maize and groundnuts
• Other foods, including sorghum, tree nuts, spices and
processed cassava, can also be important sources of
aflatoxins but contain lower levels or constitute smaller shares
of diet; animal source foods especially milk
• Animal feed (concentrates) can be heavily contaminated
On average 40%
of commodities in local African markets exceed allowable levels
of aflatoxins in foods
Aflatoxin levels exceeding 1000 ppb are not uncommon.

13. Aflatoxin M1 in milk in some
African countries
Location Samples Positive >50 ppt >500
ppt
Max level
detected
Reference
Dar es
Salaam, TZ
37 92% 24% 855 ppt (Urio et al. 2006)
Nairobi,
Kenya
128 100% 63% 2,560 ppt (Kiarie et al. 2016)
Rural Kenya (4
AEZ)
512 40% 10% 0.6% 6,999 ppt (Senerwa et al.
2016)
Libya 49 71% 3,130 ppt (Elgerbi et al. 2004)
Addis Ababa,
Ethiopia
110 100% 92% 26% 4,980 ppt (Gizachew et al.
2016)
Cameroon 63 16% 9.5% 527 ppt (Tchana et al. 2010)

14. Factors influencing aflatoxin risks in
Africa
Aflatoxin
challenge
in Africa
Conducive
climatic
conditions
Complexity –
difficulty of
targeting
interventions
Heavy
reliance on
dietary
staples
Low
awareness
levels
Traditional
crop
production
practices
Weak
institutional
capacity
Groundnut shelling, Senegal 2015,
improvements needed
Photo: PACA

15. Managing aflatoxins
• Need for systemic thinking and integrated
multidisciplinary and multi-stakeholder approach
• A mix of preharvest and postharvest measures
• Proper agronomic and crop management practices
• Competitive biological control using non-aflatoxin
producing strains of A. flavus can reduce toxin levels by
80-90% (Atehnkeng et al. 2014).
• No commercial lines with resistance to address aflatoxin
contamination have been marketed (Brown et al., 2013)
but need to explore recent advances in plant breeding
• Proper drying to safe moisture levels
• Clean and dry storage
• Hermetic storage solutions

16. Managing aflatoxins, cont.
• Regulatory measures: enforcing max limits
• The developed world applies effective inspection of
food supplies and enforcing maximum limits for
aflatoxins
• Tradeoffs between food safety and availability cannot
be ignored
• Developing legal, alternative non-food uses for
contaminated produce
• African countries cannot continue with the status quo of
enforcing regulations only in produce destined for
export markets
• Market incentives to drive behavior change play
important role in adoption of aflatoxin control strategies
across food systems

17. The Mycotoxin Agenda:
Relevance of mycotoxin control to
meeting Malabo Declaration
Commitments, Agenda 2063, and SDGs
• Malabo Declaration Commitments on:
• #3, ending hunger in Africa by 2025
• #4, poverty reduction
• #5, tripling intra-African trade in agricultural
commodities and services
• #6, enhancing resilience of livelihoods and
production systems to climate variability and related
risks
• Sustainable Development Goal on ending
poverty and hunger

18. Role of the Partnership for
Aflatoxin Control in Africa (PACA)
• Working with country
governments, RECs and
other stakeholders and
driving systemic change in
aflatoxin mitigation in Africa
• PACA supports AU member
states from evidence
generation through
development, implementation
and progress tracking of
comprehensive aflatoxin
control action plans

19. Potential interventions for
addressing nutrition and health
impacts of mycotoxins
• Thematic area 1: Health - Targeting Hepatitis B virus
(HBV) vaccination & other control options; surveillance
and biomonitoring;
Public health policy on aflatoxin in Africa
• Thematic area 2: Agriculture - Pre-harvest practices,
post-harvest interventions;
Market demand driven technology adoption;
Alternative uses of contaminated crops;
Smallholder farmer adoption of practices
• Thematic area 3: Nutrition- Mitigating aflatoxins in
food fortification supply chains;
dietary diversification;
food processing, food quality and safety
Please refer to the key action items and stakeholder
roles in Chapter 8 of ATOR 2015.

20. Conclusions
• Aflatoxins, potent carcinogens in human and animals,
mainly get into the biological system via diets
• The human health impacts resulting from acute and
chronic aflatoxin exposure adds losses in productive
years and cost of illness, contributing to the cycle of
poverty which may contribute to further ill-health
• Several interventions are available for reducing the
adverse impacts of aflatoxins
• However, the complexity and cost of implementing the
available strategies requires effective partnerships
• There is a need to embed aflatoxin control in value
chain development efforts involving susceptible
commodities

21. Thank You