Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening.

TitleCase-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening.
Publication TypeJournal Article
Year of Publication2021
AuthorsDuringer, J, Mazumder, R, Palmer, V, A Craig, M, Spencer, P
JournalToxins (Basel)
Date Published2021 04 27
KeywordsAdolescent, Aflatoxins, Case-Control Studies, Child, Child Development, Child Nutritional Physiological Phenomena, Child, Preschool, Female, Food Microbiology, Humans, Male, Mycotoxins, Nodding Syndrome, Uganda, Zea mays, zeranol

This case-control study adds to the growing body of knowledge on the medical, nutritional, and environmental factors associated with Nodding Syndrome (NS), a seizure disorder of children and adolescents in northern Uganda. Past research described a significant association between NS and prior history of measles infection, dependence on emergency food and, at head nodding onset, subsistence on moldy maize, which has the potential to harbor mycotoxins. We used LC-MS/MS to screen for current mycotoxin loads by evaluating nine analytes in urine samples from age-and-gender matched NS cases (n = 50) and Community Controls (CC, n = 50). The presence of the three mycotoxins identified in the screening was not significantly different between the two groups, so samples were combined to generate an overall view of exposure in this community during the study. Compared against subsequently run standards, α-zearalenol (43 ± 103 µg/L in 15 samples > limit of quantitation (LOQ); 0 (0/359) µg/L), T-2 toxin (39 ± 81 µg/L in 72 samples > LOQ; 0 (0/425) µg/L) and aflatoxin M1 (4 ± 10 µg/L in 15 samples > LOQ; 0 (0/45) µg/L) were detected and calculated as the average concentration ± SD; median (min/max). Ninety-five percent of the samples had at least one urinary mycotoxin; 87% were positive for two of the three compounds detected. While mycotoxin loads at NS onset years ago are and will remain unknown, this study showed that children with and without NS currently harbor foodborne mycotoxins, including those associated with maize.

Alternate JournalToxins (Basel)
PubMed ID33925470
PubMed Central IDPMC8145943
Grant List1 R01 NS079276 and R21 TW009927-01 / NH / NIH HHS / United States