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Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa

Numerous population-based studies have documented high prevalence of aflatoxin associated childhood stunting in low income countries. We provide an estimate of the disease burden of aflatoxin related stunting using data from the four African countries. For this empirical analysis, we obtained blood...

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Autores principales: Rasheed, Hifza, Xu, Ya, Kimanya, Martin E., Pan, Xiaoxi, Li, Zhihua, Zou, Xiaobo, Shirima, Candida P., Holmes, Melvin, Routledge, Michael N., Gong, Yun Yun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810982/
https://www.ncbi.nlm.nih.gov/pubmed/33452336
http://dx.doi.org/10.1038/s41598-020-80356-4
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author Rasheed, Hifza
Xu, Ya
Kimanya, Martin E.
Pan, Xiaoxi
Li, Zhihua
Zou, Xiaobo
Shirima, Candida P.
Holmes, Melvin
Routledge, Michael N.
Gong, Yun Yun
author_facet Rasheed, Hifza
Xu, Ya
Kimanya, Martin E.
Pan, Xiaoxi
Li, Zhihua
Zou, Xiaobo
Shirima, Candida P.
Holmes, Melvin
Routledge, Michael N.
Gong, Yun Yun
author_sort Rasheed, Hifza
collection PubMed
description Numerous population-based studies have documented high prevalence of aflatoxin associated childhood stunting in low income countries. We provide an estimate of the disease burden of aflatoxin related stunting using data from the four African countries. For this empirical analysis, we obtained blood aflatoxin albumin adduct biomarker based exposure data as measured using ELISA technique and anthropometric measurement data from surveys done over a 12-year period from 2001 to 2012 in four low income countries in Africa. We used these data to calculate population attributable risk (PAR), life time disease burden for children under five by comparing two groups of stunted children using both prevalence and incidence-based approaches. We combined prevalence estimates with a disability weight, measuring childhood stunting and co-occurrence of stunting-underweight to produce years lived with disability. Using a previously reported mortality, years of life lost were estimated. We used probabilistic analysis to model these associations to estimate the disability-adjusted life-years (DALYs), and compared these with those given by the Institute for Health Metrics and Evaluation’s Global Burden of Disease (GBD) 2016 study. The PAR increased from 3 to 36% for aflatoxin-related stunting and 14–50% for co-occurrence of stunting and underweight. Using prevalence-based approach, children with aflatoxin related stunting resulted in 48,965.20 (95% uncertainty interval (UI): 45,868.75–52,207.53) DALYs per 100,000 individuals. Children with co-occurrence of stunting and underweight due to exposure to aflatoxin resulted in 40,703.41 (95% UI: 38,041.57–43,517.89) DALYs per 100,000 individuals. Uncertainty analysis revealed that reducing aflatoxin exposure in high exposure areas upto non-detectable levels could save the stunting DALYs up to 50%. The burden of childhood all causes stunting is greater in countries with higher aflatoxin exposure such as Benin. In high exposure areas, these results might help guide research protocols and prioritisation efforts and focus aflatoxin exposure reduction. HEFCE Global Challenge Research Fund Aflatoxin project.
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spelling pubmed-78109822021-01-21 Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa Rasheed, Hifza Xu, Ya Kimanya, Martin E. Pan, Xiaoxi Li, Zhihua Zou, Xiaobo Shirima, Candida P. Holmes, Melvin Routledge, Michael N. Gong, Yun Yun Sci Rep Article Numerous population-based studies have documented high prevalence of aflatoxin associated childhood stunting in low income countries. We provide an estimate of the disease burden of aflatoxin related stunting using data from the four African countries. For this empirical analysis, we obtained blood aflatoxin albumin adduct biomarker based exposure data as measured using ELISA technique and anthropometric measurement data from surveys done over a 12-year period from 2001 to 2012 in four low income countries in Africa. We used these data to calculate population attributable risk (PAR), life time disease burden for children under five by comparing two groups of stunted children using both prevalence and incidence-based approaches. We combined prevalence estimates with a disability weight, measuring childhood stunting and co-occurrence of stunting-underweight to produce years lived with disability. Using a previously reported mortality, years of life lost were estimated. We used probabilistic analysis to model these associations to estimate the disability-adjusted life-years (DALYs), and compared these with those given by the Institute for Health Metrics and Evaluation’s Global Burden of Disease (GBD) 2016 study. The PAR increased from 3 to 36% for aflatoxin-related stunting and 14–50% for co-occurrence of stunting and underweight. Using prevalence-based approach, children with aflatoxin related stunting resulted in 48,965.20 (95% uncertainty interval (UI): 45,868.75–52,207.53) DALYs per 100,000 individuals. Children with co-occurrence of stunting and underweight due to exposure to aflatoxin resulted in 40,703.41 (95% UI: 38,041.57–43,517.89) DALYs per 100,000 individuals. Uncertainty analysis revealed that reducing aflatoxin exposure in high exposure areas upto non-detectable levels could save the stunting DALYs up to 50%. The burden of childhood all causes stunting is greater in countries with higher aflatoxin exposure such as Benin. In high exposure areas, these results might help guide research protocols and prioritisation efforts and focus aflatoxin exposure reduction. HEFCE Global Challenge Research Fund Aflatoxin project. Nature Publishing Group UK 2021-01-15 /pmc/articles/PMC7810982/ /pubmed/33452336 http://dx.doi.org/10.1038/s41598-020-80356-4 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Rasheed, Hifza
Xu, Ya
Kimanya, Martin E.
Pan, Xiaoxi
Li, Zhihua
Zou, Xiaobo
Shirima, Candida P.
Holmes, Melvin
Routledge, Michael N.
Gong, Yun Yun
Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa
title Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa
title_full Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa
title_fullStr Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa
title_full_unstemmed Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa
title_short Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa
title_sort estimating the health burden of aflatoxin attributable stunting among children in low income countries of africa
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810982/
https://www.ncbi.nlm.nih.gov/pubmed/33452336
http://dx.doi.org/10.1038/s41598-020-80356-4
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