Cargando…
Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004
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....
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
National Institute of Environmental Health Sciences
2005
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1314920/ https://www.ncbi.nlm.nih.gov/pubmed/16330363 http://dx.doi.org/10.1289/ehp.8384 |
_version_ | 1782126361100419072 |
---|---|
author | Azziz-Baumgartner, Eduardo Lindblade, Kimberly Gieseker, Karen Rogers, Helen Schurz Kieszak, Stephanie Njapau, Henry Schleicher, Rosemary McCoy, Leslie F. Misore, Ambrose DeCock, Kevin Rubin, Carol Slutsker, Laurence |
author_facet | Azziz-Baumgartner, Eduardo Lindblade, Kimberly Gieseker, Karen Rogers, Helen Schurz Kieszak, Stephanie Njapau, Henry Schleicher, Rosemary McCoy, Leslie F. Misore, Ambrose DeCock, Kevin Rubin, Carol Slutsker, Laurence |
author_sort | Azziz-Baumgartner, Eduardo |
collection | PubMed |
description | 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 B(1)–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 B(1)–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. |
format | Text |
id | pubmed-1314920 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2005 |
publisher | National Institute of Environmental Health Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-13149202006-01-02 Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004 Azziz-Baumgartner, Eduardo Lindblade, Kimberly Gieseker, Karen Rogers, Helen Schurz Kieszak, Stephanie Njapau, Henry Schleicher, Rosemary McCoy, Leslie F. Misore, Ambrose DeCock, Kevin Rubin, Carol Slutsker, Laurence Environ Health Perspect Research 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 B(1)–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 B(1)–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. National Institute of Environmental Health Sciences 2005-12 2005-08-09 /pmc/articles/PMC1314920/ /pubmed/16330363 http://dx.doi.org/10.1289/ehp.8384 Text en http://creativecommons.org/publicdomain/mark/1.0/ Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, ?Reproduced with permission from Environmental Health Perspectives?); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright. |
spellingShingle | Research Azziz-Baumgartner, Eduardo Lindblade, Kimberly Gieseker, Karen Rogers, Helen Schurz Kieszak, Stephanie Njapau, Henry Schleicher, Rosemary McCoy, Leslie F. Misore, Ambrose DeCock, Kevin Rubin, Carol Slutsker, Laurence Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004 |
title | Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004 |
title_full | Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004 |
title_fullStr | Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004 |
title_full_unstemmed | Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004 |
title_short | Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004 |
title_sort | case–control study of an acute aflatoxicosis outbreak, kenya, 2004 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1314920/ https://www.ncbi.nlm.nih.gov/pubmed/16330363 http://dx.doi.org/10.1289/ehp.8384 |
work_keys_str_mv | AT azzizbaumgartnereduardo casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT lindbladekimberly casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT giesekerkaren casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT rogershelenschurz casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT kieszakstephanie casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT njapauhenry casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT schleicherrosemary casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT mccoyleslief casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT misoreambrose casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT decockkevin casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT rubincarol casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT slutskerlaurence casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 AT casecontrolstudyofanacuteaflatoxicosisoutbreakkenya2004 |