OF SICK TURKEYS, KWASHIORKOR, MALARIA, PERINATAL-MORTALITY, HEROIN-ADDICTS AND FOOD POISONING - RESEARCH ON THE INFLUENCE OF AFLATOXINS ON CHILD HEALTH IN THE TROPICS

Similarities between the geographical and climatic prevalences of kwas hiorkor and of exposure to dietary aflatoxins, and between the biochem ical, metabolic and immunological derangements in kwashiorkor and thos e in animals exposed to aflatoxins, prompted investigation of the asso ciations between kwashiorkor and aflatoxins. Studies in Africa in the 1980s indicated a role for these toxins in the pathogenesis of the dis ease. Paediatric cases of kwashiorkor are less prone to severe Plasmod ium falciparum malaria than normal children. In mice infected with P. berghei, aflatoxin exposure inhibits parasite growth and ameliorates m orbidity. Aflatoxins occur in less than or equal to 40% of samples of breast milk from tropical Africa, usually as low concentrations of the relatively non-toxic derivatives of aflatoxin Bi (AFB(1)) but sometim es as high concentrations of the very toxic AFB(1). This could explain kwashiorkor in breast-fed babies. Aflatoxin exposure occurs in greate r than or equal to 30% of pregnancies in tropical Africa and the toxin s are often in cord blood, sometimes at extremely high concentrations. Aflatoxins are now incriminated in neonatal jaundice and there is cir cumstantial evidence that they cause perinatal death and reduced birth weight. Aflatoxin-induced immunosuppresion may explain the aggressive behaviour of HIV infection in Africa. There are similarities between o bservations on HIV cases in Africa and those on heroin addicts in Euro pe, where 'street' heroin is frequently contaminated with aflatoxin. A flatoxins were found in 20% of random urine samples from heroin addict s in the U.K. and the Netherlands. Aflatoxins have also been incrimina ted in episodes of food poisoning which have been associated with seri ous morbidity and mortality, particularly among young children.