A group of five children with
kwashiorkor, seven with marasmic
kwashiorkor and one underweight child were given an
aflatoxin-free diet consisting of maize meal and milk
powder. Blood specimens were collected on admission; on day 4 and 10, 24 hour urine and stool samples were collected for the first ten days. Serum, urine and stool samples were analysed for
aflatoxins using high performance liquid chromatography with fluorescent detection, after various extraction and clean-up procedures. The children with
kwashiorkor and marasmic
kwashiorkor excreted
aflatoxins in stools for up to 9 and 6 days after admission respectively. No
aflatoxins were detected in the stools or urine of the underweight child. In
kwashiorkor, urinary excretion ceased after 2 days, while in marasmic
kwashiorkor urinary excretion persisted for 4 days. In stools, B1 was the type of
aflatoxin detected most frequently in
kwashiorkor and least frequently in marasmic
kwashiorkor.
Aflatoxin M2 was frequently detected in the stools of both groups of children. Estimates of the total amount of
aflatoxin excreted by
kwashiorkor and marasmic
kwashiorkor indicate that these children were harbouring up to 4 micrograms/kg
body weight at the time of admission. These findings establish that
aflatoxins accumulate in body fluids and tissues in
kwashiorkor and marasmic
kwashiorkor which is only slowly eliminated.