Abstract
Acute aflatoxicosis outbreaks sporadically occur among subsistence farmers in Makueni and Kitui districts, Eastern Province, Kenya. Over the past 25 years, four documented outbreaks of acute aflatoxicosis affecting 467 individuals and resulting in 178 deaths have occurred in the same region. The outbreaks occurred in the southeastern part of Eastern Province between the months of April and July. The outbreaks resulted from the consumption of aflatoxin contaminated homegrown maize. Analysis of homestead and market maize samples collected from the affected region showed widespread contamination with aflatoxin at concentrations above 20 μg/kg. Approximately 18% of the samples were contaminated with aflatoxin at concentrations above 1, 000 μg/kg. Consumption of the contaminated maize (once or multiple times) could have resulted in estimated mean aflatoxin ingestion of 50 to 2, 500 ng/kg bw/day, with a few individuals probably ingesting as high as 18, 000 ng aflatoxin/kg bw/day. The exact cause of the aflatoxin contamination of the maize crop in this specific region has not been fully established. Circumstantial evidence suggests that weather and agricultural practices may have created favorable conditions for the proliferation of a prevalent and highly aflatoxigenic Aspergillus strain in the maize crop resulting in the production of high levels of aflatoxin in the harvested maize.
