Blood and urine samples from 252 Sudanese children were investigated for their
aflatoxin content by high-performance liquid chromatography. The children comprised 44 with
kwashiorkor, 32 with marasmic
kwashiorkor, 70 with
marasmus, and 106 age-matched, normally nourished controls.
Aflatoxins were detected more often and at higher concentrations in sera from children with
kwashiorkor than in the other malnourished and control groups.
Aflatoxicol, a metabolite of
aflatoxins B1 and B2, was detected in the sera of children with
kwashiorkor and marasmic
kwashiorkor but not in the controls and only once in a marasmic child. The difference between children with
kwashiorkor or marasmic
kwashiorkor and those in the control or
marasmus groups was significant. Urinary
aflatoxin was most often detected in children with
kwashiorkor but their mean concentration was lower than in the other groups.
Aflatoxicol was not detected in urine in any group. These findings suggest either that the children with
kwashiorkor have a greater exposure to
aflatoxins or that their ability to transport and excrete
aflatoxins is impaired by the metabolic derangements associated with
kwashiorkor. The presence of
aflatoxicol in the sera of children with
kwashiorkor but not in the others suggests a difference in metabolism between the two groups. Further studies are needed, and measurement of
aflatoxins in the food eaten by these children is already underway.