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Guinea: Low Cost Approaches to Reducing the Disease Burden from Contaminated Groundnuts

Guinea: Low Cost Approaches to Reducing the Disease Burden from Contaminated Groundnuts . Paul C. Turner Maryland Institute for Applied Environmental Health THIS WORK WAS SUPPORTED BY A GRANT FROM THE NIEHS, USA ES06052. Aflatoxins in Foods from 4 Villages in Lower Guinea - Nov/Dec.

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Guinea: Low Cost Approaches to Reducing the Disease Burden from Contaminated Groundnuts

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  1. Guinea: Low Cost Approaches to Reducing the Disease Burden from Contaminated Groundnuts Paul C. Turner Maryland Institute for Applied Environmental Health THIS WORK WAS SUPPORTED BY A GRANT FROM THE NIEHS, USA ES06052

  2. Aflatoxins in Foods from 4 Villages in Lower Guinea - Nov/Dec Food samples Village no. positive (%) Peanuts Rice Corn Bangouya 9/13 (69) 0/15 1/3 (33) Sougueta 5/9 (56) 0/14 1/3 (33) Kolente 8/9 (89) 0/19 0/3 Friguiagbe 6/15 (40) 0/18 0/0 Total 28/46 (61) 0/66 2/9 (22) Other foods all negative for aflatoxins (soup, sorghum, manio, fonio, milk, potato leaves)

  3. Clinical Trials Aflatoxin Prevention Studies Primary Prevention Chemoprevention Africa and China Reduction in aflatoxin exposure

  4. Guinea Intervention Study Intervention Control Groundnut drying Mat 150 (100%) 10 (7%) Ground 79 (53%) Mixed 61 (41%) Hand sorting 150 (100%) 52 (35%) Type of bag Natural fibre 150 (100%) 4 (3%) Plastic 107 (71%) Mixed 39 (26%) Wood pallet 150 (100%) 6 (4%) Other 70 (47%) None 74 (49%) Insecticide use 150 (100%) 19 (13%)

  5. Guinea Intervention Study Intervention Control Groundnut drying Mat 150 (100%) 10 (7%) Ground 79 (53%) Mixed 61 (41%) Hand sorting 150 (100%) 52 (35%) Type of bag Natural fibre 150 (100%) 4 (3%) Plastic 107 (71%) Mixed 39 (26%) Wood pallet 150 (100%) 6 (4%) Other 70 (47%) None 74 (49%) Insecticide use 150 (100%) 19 (13%)

  6. Multivariable models of serum AF-albuminat the two follow-up surveys Survey 2 Survey 3 GM ( 95% CI ) GM ( 95% CI )) Individual level intervention 12.7 ( 7.8, 20.7) 8.0 (6.1,10.5)** control 15.5 (9.5,25.0) 18.4 (14.2,24.0) Village mean level intervention 12.3 (11.2,13.5)** 8.2 (7.8,8.5)** control 17.6 (16.1,19.3) 18.7 (17.8,19.5) Approx 60% reduction ** p<0.001

  7. Are there any issues / problems • Focus on ground nut – Maize? • JIFSAN et al collaborations • Whilst cost is low it is not insignificant • What is / are the most effective components? • What happens to any discarded food items • Sustainability • Are any INTERVENTION components lost from the system • Large educational components

  8. What else?? From year to year will there be added benefit from the previous success? What about co-exposures – AF and FB in maize Are interventions that demonstrate etiology in the child health arena needed – are such interventions different in nature to sustainable interventions of a more global nature

  9. Acknowledgements • Institut Pasteur de Guinée, Kindia, Republic of Guinea • Sylla, A. Diallo M • University of Leeds, UK • Gong, Y, Sutcliffe A.E. • IARC, France • Wild CP • London School of Hygiene & Tropical Medicine, UK • Hall AJ

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