Case-control study of an acute aflatoxicosis outbreak, Kenya, 2004.
Environ Health Perspect
; 113(12): 1779-83, 2005 Dec.
Article
em En
| MEDLINE
| ID: mdl-16330363
ABSTRACT
OBJECTIVES:
During January-June 2004, an aflatoxicosis outbreak in eastern Kenya resulted in 317 cases and 125 deaths. We conducted a case-control study to identify risk factors for contamination of implicated maize and, for the first time, quantitated biomarkers associated with acute aflatoxicosis.DESIGN:
We administered questionnaires regarding maize storage and consumption and obtained maize and blood samples from participants.PARTICIPANTS:
We recruited 40 case-patients with aflatoxicosis and 80 randomly selected controls to participate in this study. EVALUATIONS/MEASUREMENTS We analyzed maize for total aflatoxins and serum for aflatoxin B1-lysine albumin adducts and hepatitis B surface antigen. We used regression and survival analyses to explore the relationship between aflatoxins, maize consumption, hepatitis B surface antigen, and case status.RESULTS:
Homegrown (not commercial) maize kernels from case households had higher concentrations of aflatoxins than did kernels from control households [geometric mean (GM) = 354.53 ppb vs. 44.14 ppb; p = 0.04]. Serum adduct concentrations were associated with time from jaundice to death [adjusted hazard ratio = 1.3; 95% confidence interval (CI), 1.04-1.6]. Case patients had positive hepatitis B titers [odds ratio (OR) = 9.8; 95% CI, 1.5-63.1] more often than controls. Case patients stored wet maize (OR = 3.5; 95% CI, 1.2-10.3) inside their homes (OR = 12.0; 95% CI, 1.5-95.7) rather than in granaries more often than did controls.CONCLUSION:
Aflatoxin concentrations in maize, serum aflatoxin B1-lysine adduct concentrations, and positive hepatitis B surface antigen titers were all associated with case status. RELEVANCE The novel methods and risk factors described may help health officials prevent future outbreaks of aflatoxicosis.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Contaminação de Alimentos
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Surtos de Doenças
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Zea mays
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Aflatoxinas
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Doenças Transmitidas por Alimentos
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
País/Região como assunto:
Africa
Idioma:
En
Revista:
Environ Health Perspect
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Estados Unidos