Assessment of Co-Exposure of Aflatoxin, Lead and Cadmium in Children at Ejura Sekyedumase District, Ashanti Region of Ghana.

Abstract

Background Major public health risks in Ghana are caused by aflatoxins and heavy metals, and children are more vulnerable because of their developing bodies and greater rates of consuming contaminated food and water. Aflatoxins are produced by Aspergillus fungus, which are common in staple foods like groundnuts and maize. This toxin when it exceeds safety thresholds, can cause immunological suppression, liver damage, and stunted growth. Soil, water, and food are most times contaminated by heavy metals like lead and cadmium. And this is as a result of mining, industrial processes, and inappropriate e-waste disposal. These toxic metals can cause severe health problems including neurodevelopmental disorders, kidney damage and cancer. Aim To assess the effects of aflatoxins and heavy metals on the kidneys and liver biomarkers of children from Ejura Sekyedumase District in the Ashanti Region of Ghana. Method The study design was a cross-sectional one. One hundred and sixty-two (162) participants between the ages of 3 and 9 were recruited from the Ejura-Sekyedumase district for this study. Blood, (5mLs) was taken from the antecubital fossa vein in the upper arm of all participants. The blood was divided into two, 2 mLs into EDTA and 3 mL into serum gel tube labeled with participant’s name and identification number. Whole blood specimen (EDTA tube) was used to analyze reduced glutathione and full blood count using KX Sysmex 21(Sysmex Corporation, Japan). Serum samples were used to analyze heavy metals using Graphite Furnace Atomic Absorption Spectrometer (GFAAS; PinAAcle 900H), liver and kidney bioarkers using KX Sysmex chemistry automated analyzer (Sysmex Corporation, Japan). Spot urine was collected from participants and used to run aflatoxin levels using Shimadzu HPLC system with fluorescence detection (Shimadzu Corporation, Japan). All analyses of data obtained were performed in R (version 4.3.2; R Foundation for Statistical Computing, Vienna, Austria) within the RStudio environment. Results In this study, there were elevated concentrations of aflatoxins in 26 males and 24 females’ participants. No sex-specific differences in Cd, Pb and AFM1 levels between males and females. Hematological parameters demonstrated significant positive correlations, particularly between AFM1 and neutrophil count and between Pb and albumin levels. Although the antioxidant biomarker GSH showed negative correlations with all three exposures, none of the correlations were statistically significant. In the overall sample, none of the exposures (Cd, Pb, or AFM1) demonstrated significant associations with glutathione (GSH), haemoglobin, or most haematological parameters. The combined exposure to cadmium, lead, and aflatoxin M1 showed generally non-significant associations with most haematological and biochemical biomarkers protein, sodium, while AFM1 strongly influenced ALT and monocytes, and lead contributed most to chloride and AST. Conclusion This study revealed a high concentration of aflatoxin M1(AFM1) in the urine of participants. AFM1 showed a negative correlation with monocytes and positively correlated with urea which can result in immunosuppression and kidney disease respectively. Lead showed positive correlation with chlorine whereas cadmium had a positive association with potassium which can cause metabolic dysfunction in the future. The findings from this study emphasize the need to put in measures to prevent aflatoxin and heavy metals from contaminating our foods.