The effect of aflatoxin b1 serum albumin adducts level 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 had been reported over the years in parts of lower eastern Kenya including Kitui and Makueni counties. Ingestion of aflatoxin B1 contaminated food stuff at certain levels cause aflatoxicosis which manifests as hepatoxicity and in severe cases, fulminant liver failure. A study was therefore conducted to evaluate the effect of AFB1 lysine albumen adducts level and therefore, impact of dietary AFB1 levels on persons with liver disease. Methodology: The investigation was conducted as a case-control study where blood samples from appropriately selected subjects was analyzed for exposure and non exposure to dietary aflatoxinB1 (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 determined as 283 for both case and control subjects as per Schelsselman formula (1982). Blood samples were drawn, frozen and stored for analysis and determination of AFB1 lysine albumen adducts. Findings: Case subjects had 55.83% (n=158) of serum sample positive for AFB1 lysine albumin adducts with a level range of 15.50 pg/mg to 135.00 pg/mg and a mean of 42.93 pg/mg (95%; CI: 39.36 to 46.51) p≤ 0.05, while the controls with 31.0% (n=88) of positive samples had a lower AFB1 lysine albumin adducts level range of 3.50 pg/mg to 60.50 pg/mg with a mean of 14.30 pg/mg (95%; CI: 12.23 to 16.36), p≤ 0.05. Case subjects had higher mean level for AFB1 lysine albumin adducts than controls, suggesting higher level of dietary AFB1 exposure. This study therefore, exposed dietary aflatoxin B1 as one of the endemic etiological agents for 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 influence use of innovative methods of preventing infestation of moulds, especially those of the genus A. flavus in grains and cereals, which produce aflatoxin B1 and eventually contaminate most types of cereals.