Human Aflatoxin Exposure in Kenya, 2007: a Cross-Sectional Study

Background: Aflatoxins contaminate approximately one-quarter of agricultural products worldwide. They can cause liver failure and liver cancer. Kenya has experienced multiple aflatoxicosis outbreaks in recent years, often resulting in fatalities. However, the full extent of aflatoxin exposure in Kenya has been unknown. Aims: To quantify aflatoxin exposure across Kenya and to compare aflatoxin exposure by demographic, socioeconomic, and geographic characteristics. Methods: We analyzed aflatoxin levels in serum specimens from the 2007 Kenya AIDS Indicator Survey (KAIS)—a nationally-representative, cross-sectional serosurvey. KAIS collected 15,853 blood specimens. Of the 3,180 HIV-negative specimens with =1mL sera, we randomly selected 600 specimens stratified by province and sex. We analyzed serum specimens for aflatoxin albumin adducts using isotope dilution tandem mass spectrometry to quantify aflatoxin B1-lysine (AFB1-lys), and normalized with serum albumin. Aflatoxin concentrations were then compared by...