Aflatoxins are common environmental hazards in all the underdeveloped countries of the tropics where they commonly contaminate food. They are toxic to most species of animals and are among the most powerful carcinogenic agents known. The liver is the principal target for toxicity. Metabolic derangements caused by
aflatoxins include depression of
protein and
enzyme synthesis, disorder of lipid metabolism and immunological suppression. The aetiology and pathogenesis of
kwashiorkor remains somewhat obscure. Similarities in the geographical and climatic prevalence of
kwashiorkor and
aflatoxins and similarities in the metabolic derangements caused by
aflatoxins and those observed in
kwashiorkor, prompted investigation of the relationship between
aflatoxin and
kwashiorkor in the Sudan and elsewhere in Africa. Analysis of foods from markets and in homes revealed widespread
aflatoxin contamination.
Aflatoxins were found more frequently and at higher concentrations in the serum of children with
kwashiorkor than in those with other types of
malnutrition or in normal children.
Aflatoxicol, a metabolite of
aflatoxin B1 was detected in serum in
kwashiorkor and marasmic
kwashiorkor but not in normally nourished children and only once in
marasmus. Autopsy liver samples from West and Southern Africa have shown
aflatoxins in all cases of
kwashiorkor but not in
marasmus. These findings establish relationships between
aflatoxin and
kwashiorkor the nature of which remains obscure but includes the possibility of a causal association.