Prevalence and concentration of Aflatoxin M1 in human breast milk in sub-Saharan Africa: a systematic review and meta-analysis, and cancer risk assessment

ABSTRACT

This study aimed to assess the prevalence, concentration of AFM1 in human breast milk, and to determine the risk of cancer for infants in sub-Saharan Africa. A systematic literature search was performed using PubMed, CINAHL, Web of science, global health, Cochrane, and Google Scholar electronic databases. A random-effects model was used to estimate the pooled prevalence and concentration of AFM1 in breast milk. The meta-analysis of 8 articles containing 9 studies showed the pooled prevalence of AFM1 in breast milk to be 56.18% (95% CI: 29.65–82.71) and the pooled concentration to be 31.12 ng/L (95% CI: 25.97–36.25). The cancer risk assessment indicated for both male and female 1-month infants in Sierra Leone (HI > 1) is high, and all the rest of the infants are free of risk (HI < 1). The pooled prevalence and mean concentration of AFM1 in breast milk is high. Monitoring of AFB1 concentration of commonly used foods will be of high value in reducing the burden of AFM1.

KEYWORDS:

• Aflatoxin
• AFM1
• breast milk
• cancer
• sub-Saharan Africa

Acknowledgment

We acknowledge the authors and participants of the included original studies in this systematic review and Meta-analysis.

Authorsʻ contributions

Robel Hussen Kabthymer conceived the idea and had a major role in the data review, extraction, and analysis. Girum Gebremeskel Kanno had also a role in data extraction. All authors have contributed to the analysis, writing, drafting, and editing. All the authors read and gave final approval for the manuscript.

Availability of data and materials

Data used in this study can be accessed by requesting the corresponding author.

Ethical approval

The procedures used in this study respect the scientific ethical rules.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.