Is Aflatoxin a Threat to Human-Health in Ethiopia? A Systematic Review
2020
Background: Aspergilli are one of the major causes of degradation of agricultural products, as they can contaminate foods and feeds at different stages including pre- and post-harvest, processing, and handling. Besides, mainly A. niger, A. flavus, and A. fumigatus species are also causes of animal and human diseases, like mycotoxicosis, noninvasive, and invasive infections in immune-compromised patients, and hypersensitive reactions (e.g., asthma, allergic alveolitis) due to exposure to fungal fragments. Aflatoxin is one of the causes of the deadly hepatocellular carcinoma. Methods: Electronic search in Pub-Med /MEDLINE and Google was conducted to find published literature with the English language. Reference lists of relevant articles were searched manually. We used search terms like “aflatoxin AND Ethiopia”, “mycotoxin AND Ethiopia”, and “aflatoxin AND Hepatocellular carcinoma AND Ethiopia”. Titles and abstracts were initially screened for eligibility. The full texts of articles judged to be eligible were reviewed if they meet the inclusion criteria. Data were extracted on important variables like the sample size, region of the study, the food commodities studied, level of aflatoxin detected, aflatoxin detection rate, and more other variables. Microsoft Excel was used for data extraction. Results: The electronic searches identified 52 articles of which 19 were found eligible. Most parts of the country were covered by the articles. The food commodities that were assessed by the studies include cereals like maize, sorghum, teff, wheat, barley, peas, beans, and groundnut. Milk was also assessed for aflatoxin. Similarly, beer samples were assessed for aflatoxin content in one article. Most of the studies reported aflatoxin contamination in the food items studied. Parts of the food items contained aflatoxin beyond the limit put by the different regulatory bodies like the East African standard, European commission, and food and drug administration (FDA). We were not able to retrieve articles that assessed hepatocellular carcinoma and its association with aflatoxin in Ethiopia. Conclusion and recommendation: Aflatoxin contamination of food commodities intended for human consumption is a vast problem. Though the association of aflatoxin contamination in food commodities and hepatocellular carcinoma was not assessed in Ethiopia, it was confirmed elsewhere to be associated with hepatocellular carcinoma. Hence, the regulatory bodies in Ethiopia and policymakers shall work on creating awareness, putting ways of limiting and avoiding aflatoxins in food commodities intended for human consumption.
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