Childhood stunting has long term consequences on both later morbidity and mortality. In many developing regions of the world insufficient nutrition and gastrointestinal infection in the first few years of life are significant drivers of stunting. However, only about 50% of the poor growth is explained by these risk factors. A number of studies from Sub-Saharan Africa reveal strong associations between aflatoxin exposure and poor infant growth. Aflatoxins, secondary toxic metabolites of certain Aspergillus fungi, are frequent contaminants of dietary staples in many subsistence farming populations, and cause both acute and chronic disease. In high risk regions more than 90% of the population have chronic aflatoxin exposure at moderate to high levels; while globally several billion persons live in regions with some risk of exposure occurring. The studies in infants also highlight the critical role of weaning in aflatoxin exposure, thus offer a potentially simple approach to delay exposure. In this presentation I will review some of these data, including maternal and infant aflatoxin exposure; provide suggestive mechanisms, and introduce novel studies that seek to improve our understanding of the multiplicative contributions of aflatoxin, poor hygiene and nutrition on child health.  While aflatoxin exposure dominates the mycotoxin issue on growth we are increasingly aware of exposure to additional mycotoxin families including the fumonisins and the trichothecenes. The possible contribution of these mycotoxins will be considered in these novel investigations.

Aflatoxin and child growth: The critical first 1000 days of life in underdeveloped world regions

251st National Meeting (2016)

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