Is the narrow focus on aflatoxins in sub-Saharan Africa plausible

Aflatoxins are the most commonly known and thoroughly studied mycotoxins. They are considered to be among the most toxic mycotoxins and have been implicated in epidemics of liver disease. In spite of substantive linkage between aflatoxins B1 and human hepatic/extra-hepatic carcinogenesis, in some cases the etiology of the disease could not be unequivocally established [Tandon et al., 1978, Arch Pathol Lab Med 102(7):372-376]. Despite evidence of synergistic interaction of mycotoxins, in instances where the relationship seem fairly tenable, there is no record of assays of other mycotoxins which might have co-occurred with the aflatoxins and augmented the epidemics [Lewis et al., 2005, Environ Health Persp 1763-1767; Probst et al., 2007, Appl. Environ. Microbiol.73(8), 2762-2764]. Likewise, aflatoxin is virtually the sole focus in developing countries including those in sub-Saharan Africa. In contrast, recent multi-mycotoxins surveys collaboratively done with oversea laboratories indicate widespread co-occurrence of mycotoxins in staple foods in Africa. Moreover, mycotoxins other than aflatoxins have been repeatedly found to be more prevalent and in much high concentrations. While recognizing the potential toxicity of the aflatoxins, this article critically examines the rationale of the narrow focus on aflatoxins in Africa.