A Cross-Sectional Association Between Serum Aflatoxin and Micronutrient Status Among Children Aged 6–24 Months in Rural Tanzania

Micronutrient deficiencies are a significant public health problem, particularly affecting children under five, caused by inadequate intake of micronutrient-rich foods or environmental factors like aflatoxin exposure. Three hundred sixty-nine children aged 6–24 months from Tanzania's Babati and Hanang districts participated in this study. Serum aflatoxin albumin adduct (AF-alb) levels were assessed as measures of aflatoxin exposure. Haemoglobin levels, serum ferritin, C-reactive protein, zinc and vitamins A, B9, and B12 were assessed to determine anaemia and deficiencies in iron, zinc and vitamins A, B9 and B12 based on WHO cut-off points. Seventy per cent of the children had detectable levels of AF-alb. The AF-alb geometric mean was 5.99 (95% CI: 5.99, 6.87) pg/mg. Of those with measured micronutrient markers, 37% were anaemic, and 33%, 75%, 4%, 4% and 73% were deficient in iron, zinc, vitamins A, B9 and B12, respectively. The child's age, gender and stunting were all significantly associated (p < 0.05) with anaemia and deficiencies in zinc, vitamin A and B12. Moreover, AF-alb was associated with iron deficiency even after adjusting for confounders; children with high AF-alb levels ( > 6.07 pg/mg) were 1.40 times more likely to be iron deficient (AOR = 1.40, 95% CI: 1.11, 1.74). The high prevalence of micronutrient deficiencies and its association with aflatoxin exposure among young children highlights the urgent need for comprehensive intervention strategies, such as improving dietary diversity and enhancing food safety to reduce aflatoxin exposure. Importantly, longitudinal research is needed to understand the causal effect relationship between aflatoxin exposure and micronutrient deficiencies.