Browsing by Author "Auma, Carolyn"

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A Cross‐Sectional Association Between Serum Aflatoxin and Micronutrient Status Among Children Aged 6–24 Months in Rural Tanzania
(John Wiley & Sons, Ltd., 2025) Mshanga, Naelijwa; Kassim, Neema; Suchaya Sonto; Haikael, Martin; Pirani, Monica; Sally Moore; Auma, Carolyn; Kimanya, Martin; Yun Yun Gong
Micronutrient deficiencies are a significant public health problem, particularly affecting children under five, caused by inadequate intake of micronutrient‐rich foods or environmental factors like aflatoxin exposure. Three hundred sixty‐nine children aged 6–24 months from Tanzania's Babati and Hanang districts participated in this study. Serum aflatoxin albumin adduct (AF‐alb) levels were assessed as measures of aflatoxin exposure. Haemoglobin levels, serum ferritin, C‐reactive protein, zinc and vitamins A, B9, and B12 were assessed to determine anaemia and deficiencies in iron, zinc and vitamins A, B9 and B12 based on WHO cut‐off points. Seventy per cent of the children had detectable levels of AF‐alb. The AF‐alb geometric mean was 5.99 (95% CI: 5.99, 6.87) pg/mg. Of those with measured micronutrient markers, 37% were anaemic, and 33%, 75%, 4%, 4% and 73% were deficient in iron, zinc, vitamins A, B9 and B12, respectively. The child's age, gender and stunting were all significantly associated (p < 0.05) with anaemia and deficiencies in zinc, vitamin A and B12. Moreover, AF‐alb was associated with iron deficiency even after adjusting for confounders; children with high AF‐alb levels ( > 6.07 pg/mg) were 1.40 times more likely to be iron deficient (AOR = 1.40, 95% CI: 1.11, 1.74). The high prevalence of micronutrient deficiencies and its association with aflatoxin exposure among young children highlights the urgent need for comprehensive intervention strategies, such as improving dietary diversity and enhancing food safety to reduce aflatoxin exposure. Importantly, longitudinal research is needed to understand the causal effect relationship between aflatoxin exposure and micronutrient deficiencies.
Association Between Aflatoxin Exposure and Haemoglobin, Zinc, and Vitamin A, C, and E Levels/Status: A Systematic Review
(MDPI, 2025-02-28) Mshanga, Naelijwa; Moore, Sally; Kassim, Neema; Martin, Haikael; Auma, Carolyn; Gong, Yun
Background: Aflatoxin, produced by Aspergillus flavus and Aspergillus parasiticus fungi, contaminates a broad range of crops such as maize, nuts, and cotton. Aflatoxin exposure causes growth failure, immune suppression, and liver cancer. While several systematic reviews have assessed the link between aflatoxin exposure and growth development in humans, there is a lack of reviews on the associations between aflatoxin exposure and micronutrient levels/status. This review addresses that gap by compiling studies on the association between aflatoxin exposure and micronutrient levels/status in humans. Methods: A comprehensive search of the SCOPUS, PUBMED, EMBASE, and Web of Science databases was conducted, focusing on studies published between 2003 and 2023. Only English-language studies using urine, blood, serum, or plasma biomarkers were included to assess the exposure and outcomes. The risk of bias in these studies was evaluated using the Academy of Nutrition and Dietetics Quality Criteria for human studies. Results: Ten observational studies were included in the systematic review, which collectively reported the association between aflatoxin exposure and haemoglobin, zinc, and vitamin A, E, and C levels. This review suggests that aflatoxin exposure is associated with micronutrient deficiencies, such as anaemia (low haemoglobin levels (<11 g/dL)) in pregnant women and vitamin A deficiency in adults and children. Conclusions: This review highlights the link between aflatoxin exposure and micronutrient deficiencies, emphasizing the need for aflatoxin mitigation within micronutrient interventions. Future studies should focus on longitudinal and interventional research to establish causal relationships and assess the effectiveness of mitigation strategies. Additionally, further research is needed to explore the interaction between aflatoxin exposure and other potential confounding factors such as dietary patterns, socioeconomic status, and genetic predisposition.
Prevalence and Factors Associated with Anaemia and Undernutrition Among Children Aged 6–24 Months in Rural Tanzania
(MDPI, 2025-06-19) Mshanga, Naelijwa; Moore, Sally; Kassim, Neema; Auma, Carolyn; Gong, Yun Yun; Martin, Haikael
Background: Anaemia and undernutrition remain a significant public health problem in low and middle-income countries (LMICs), particularly affecting under-five children. In Tanzania, the prevalence of anaemia and undernutrition in under-five children is still high; however, less is known about the prevalence and predictors of these conditions in rural areas. Therefore, the current cross-sectional study presents the prevalence and determinants of anaemia and undernutrition among 457 children aged 6–24 months in the Babati and Hanang districts of Tanzania. Method: Haemoglobin concentration was assessed through capillary blood samples. Anaemia was classified according to WHO 2011 guidelines using a cut-off of <11.0 g/dL for children under five, while the WHO 2006 growth indicators were used to classify the nutritional status (i.e., stunting, wasting and underweight). Results: The results from this study show that 32%, 32%, 20% and 4% of children aged 6–24 months were anaemic, stunted, underweight and wasted, respectively, while only 33% had an adequate minimum dietary diversity (MDD). In addition, the child’s age (13–24 months) was significantly associated with anaemia (AOR: 2.1 95% CI 1.4, 3.1), stunting (AOR:17.4 95% CI 10.3, 29.4) and underweight (AOR: 15.9 95% CI 7.9, 32.0). Moreover, male children were three times more likely to be wasted (AOR: 3.5 95% CI 1.1, 10.9) than their female counterparts. Anaemia and stunting were the most prevalent nutritional disorders among 6–24-month-old children in the Hanang and Babati districts. Moreover, age (13–24 months) was found to be the common predictor for anaemia, stunting and underweight. Conclusion: The observed association between age and anaemia, as well as undernutrition, suggest that age may be an essential factor when designing nutrition-related programs in similar rural settings.