Association between anemia and aflatoxin B 1 biomarker levels among pregnant women in Kumasi, Ghana

Faisal M.B. Shuaib, Pauline E. Jolly, John E. Ehiri, Yi Jiang, William O. Ellis, Jonathan K. Stiles, Nelly J. Yatich, Ellen Funkhouser, Sharina D. Person, Craig Wilson, Jonathan H. Williams

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Aflatoxins are fungal metabolites that contaminate staple food crops in many developing countries. Up to 40% of women attending a prenatal clinic in Africa may be anemic. In a cross-sectional study of 755 pregnant women, Aflatoxin B 1-lysine adducts (AF-ALB) levels were determined by high-performance liquid chromatography. Participants were divided into quartiles "low," "moderate," "high," and "very high." Anemia was defined as hemoglobin levels < 11 g/dL. Logistic regression was used to examine the association of anemia with AF-ALB. The mean AF-ALB level was 10.9 pg/mg (range = 0.44-268.73 pg/mg); 30.3% of participants were anemic. The odds of being anemic increased 21% (odds ratio [OR], 1.21, P = 0.01) with each quartile of AF-ALB reaching an 85% increased odds in the "very high" compared with the "low" category (OR, 1.85; confidence interval [CI], 1.16-2.95). This association was stronger among women with malaria and findings were robust when women with evidence of iron deficiency anemia were excluded. This study found a strong, consistent association between anemia in pregnancy and aflatoxins.

Original languageEnglish (US)
Pages (from-to)1077-1083
Number of pages7
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number5
StatePublished - Nov 2010

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases


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