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. 2010 Nov;83(5):1077-83.
doi: 10.4269/ajtmh.2010.09-0772.

Association between anemia and aflatoxin B1 biomarker levels among pregnant women in Kumasi, Ghana

Faisal M B Shuaib  1 , Pauline E Jolly, John E Ehiri, Yi Jiang, William O Ellis, Jonathan K Stiles, Nelly J Yatich, Ellen Funkhouser, Sharina D Person, Craig Wilson, Jonathan H Williams
Affiliations

Association between anemia and aflatoxin B1 biomarker levels among pregnant women in Kumasi, Ghana

Faisal M B Shuaib et al. Am J Trop Med Hyg. 2010 Nov.

Abstract

Aflatoxins are fungal metabolites that contaminate staple food crops in many developing countries. Up to 40% of women attending a prenatal clinic in Africa may be anemic. In a cross-sectional study of 755 pregnant women, Aflatoxin B(1)-lysine adducts (AF-ALB) levels were determined by high-performance liquid chromatography. Participants were divided into quartiles "low," "moderate," "high," and "very high." Anemia was defined as hemoglobin levels < 11 g/dL. Logistic regression was used to examine the association of anemia with AF-ALB. The mean AF-ALB level was 10.9 pg/mg (range = 0.44-268.73 pg/mg); 30.3% of participants were anemic. The odds of being anemic increased 21% (odds ratio [OR], 1.21, P = 0.01) with each quartile of AF-ALB reaching an 85% increased odds in the "very high" compared with the "low" category (OR, 1.85; confidence interval [CI], 1.16-2.95). This association was stronger among women with malaria and findings were robust when women with evidence of iron deficiency anemia were excluded. This study found a strong, consistent association between anemia in pregnancy and aflatoxins.

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