The Effect of Aflatoxin B1 Serum Albumin Adducts Levels on Subjects with and Without Liver Disease in Kitui and Makueni Regions of Lower Eastern Kenya

Abstract

Purpose: An outbreak of aflatoxicosis associated with aflatoxin B1contaminated maize grain and flour hadbeen reported over the years in parts of lower eastern Kenya including Kitui and Makueni counties.Ingestion of aflatoxinB1 contaminated food stuff at certain levels cause aflatoxicosis which manifests as hepatoxicity and in severe cases, fulminant liver failure. A study was therefore conductedto evaluate the effectof AFB1lysine albumen adductslevelandtherefore,impact ofdietary AFB1levels onpersons withliver disease. Methodology:The investigation was conductedas acase-control study where bloodsamples from appropriately selected subjectswas analyzed for exposure and non exposure todietaryaflatoxinB1 (AFB1).A non probability purposive sampling method was used to choose and divide the study area into strata with 19 clusters. The sample size (n)was determinedas283forbothcase and control subjectsas per Schelsselman formula (1982).Blood samples were drawn, frozen and stored for analysis and determination of AFB1lysinealbumen adducts.Findings:Case subjects had 55.83%(n=158) of serum sample positivefor AFB1lysine albumin adductswith a level range of 15.50pg/mgto 135.00pg/mg and a meanof42.93pg/mg(95%; CI:39.36to46.51)p≤ 0.05,whilethecontrolswith 31.0%(n=88)of positive sampleshad alowerAFB1lysinealbumin adducts levelrangeof 3.50 pg/mgto 60.50pg/mg with a mean of 14.30 pg/mg (95%; CI:12.23 to16.36), p≤ 0.05. Case subjects had higher meanlevel for AFB1lysinealbumin adducts than controls, suggesting higher level of dietaryAFB1exposure. Thisstudytherefore,exposed dietary aflatoxin B1 as one of theendemic etiological agentsfor liver disease in the region.Unique contribution to theory, practice and policy:This was the first case –control study in lower eastern Kenya to link serum AFB1 lysine albumin adduct levels to incidences of liver disease. Further, the study shall influenceuse ofinnovativemethods of preventing infestationof moulds,especially those of the genus A. flavusin grains and cereals, which produce aflatoxin B1and eventually contaminate most types of cereals