Aflatoxins in Uganda: an encyclopedic review of the etiology, epidemiology, detection, quantification, exposure assessment, reduction and control

Uganda is predominantly an agricultural country where farming employ more than 60% of the population. Aflatoxins remain a scourge in the country, unprecedentedly reducing the value of agricultural foods and in high enough exposure levels, implicated for hepatocellular carcinoma, stunted growth in children and untimely deaths. This review synthetizes the country’s major findings in relation to the mycotoxin’s etiology, epidemiology, detection, quantification, exposure assessment, control and reduction in different matrices. It also highlights some of the management strategies for aflatoxin control that could be adopted in Uganda. Review results indicate that aflatoxins in Uganda is majorly produced by Aspergillus flavus and A. parasiticus and have been reported in maize (Zea mays L.), sorghum (Sorghum bicolor L.), sesame (Sesamum indicum), beans (Phaseolus vulgaris L.), sunflower (Helianthus annus), millet (Eleusine coracana), a bovine milk-based product, peanuts (Arachis hypogaea L.) and cassava (Manihot esculenta) with the highest content reported in cassava, beans and peanuts. The causes and proliferation of aflatoxigenic contamination of Ugandan foods have been largely due to poor pre-, peri- and post-harvest activities, poor government legislation, lack of awareness and low levels of education among farmers, agri-entreprenuers and consumers on the plague. Aflatoxin B₁ is the most prevalent aflatoxin in Uganda. There is still limited research on aflatoxins in Uganda because the surveillance, reduction and control carry prohibitive costs. A few exposure assessments have been done especially in human sera and dependence on a single or a related set of foods with little diet diversity has exacerbated the risk of exposure to aflatoxins in Uganda because most of the staple foods are aflatoxin-prone. On the detection, control and reduction, these are still marginal, though some devoted scholars have devised and validated a sensitive portable device for on-site aflatoxin detection in maize as well as shown that starter cultures used for making some cereal-based beverages have the potential to bind aflatoxins. More effort should be geared towards awareness creation through training of farmers and traders in the cereal value chain as well as developing capacity to monitor aflatoxins. Vaccination against Hepatitis B and Hepatitis A should be emphasized to reduce the risk of development of liver cancer among the populace.