{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:30:35Z","timestamp":1786631435220,"version":"build-2736575974"},"reference-count":27,"publisher":"American Chemical Society (ACS)","issue":"6","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":2132,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Presentation with a firm type of chronic hepatomegaly of multifactorial etiology is common among school-age children in sub-Saharan Africa.<\/jats:p>\n                  <jats:p>Objective: Aflatoxin is a liver toxin and carcinogen contaminating staple maize food. In this study we examined its role in chronic hepatomegaly.<\/jats:p>\n                  <jats:p>Methods: Plasma samples collected in 2002 and again in 2004 from 218 children attending two schools in neighboring villages were assayed for aflatoxin exposure using the aflatoxin-albumin adduct (AF-alb) biomarker. Data were previously examined for associations among hepatomegaly, malaria, and schistosomiasis.<\/jats:p>\n                  <jats:p>Results: AF-alb levels were high in children from both schools, but the geometric mean (95% confidence interval) in year 2002 was significantly higher in Matangini [206.5 (175.5, 243.0) pg\/mg albumin] than in Yumbuni [73.2 (61.6, 87.0) pg\/mg; p &amp;lt; 0.001]. AF-alb levels also were higher in children with firm hepatomegaly [176.6 (129.6, 240.7) pg\/mg] than in normal children [79.9 (49.6, 128.7) pg\/mg; p = 0.029]. After adjusting for Schistosoma mansoni and Plasmodium infection, we estimated a significant 43% increase in the prevalence of hepatomegaly\/hepatosplenomegaly for every natural-log-unit increase in AF-alb. In 2004, AF-alb levels were markedly higher than in 2002 [539.7 (463.3, 628.7) vs. 114.5 (99.7, 131.4) pg\/mg; p &amp;lt; 0.001] but with no significant difference between the villages or between hepatomegaly and normal groups [539.7 (436.7, 666.9) vs. 512.6 (297.3, 883.8) pg\/mg], possibly because acute exposures during an aflatoxicosis outbreak in 2004 may have masked any potential underlying relationship.<\/jats:p>\n                  <jats:p>Conclusions: Exposure to aflatoxin was associated with childhood chronic hepatomegaly in 2002. These preliminary data suggest an additional health risk that may be related to aflatoxin exposure in children, a hypothesis that merits further testing.<\/jats:p>","DOI":"10.1289\/ehp.1104357","type":"journal-article","created":{"date-parts":[[2012,2,27]],"date-time":"2012-02-27T11:10:59Z","timestamp":1330341059000},"page":"893-896","source":"Crossref","is-referenced-by-count":80,"title":["Aflatoxin Exposure May Contribute to Chronic Hepatomegaly in Kenyan School Children"],"prefix":"10.1021","volume":"120","author":[{"given":"Yun Yun","family":"Gong","sequence":"first","affiliation":[{"name":"Division of Epidemiology, Leeds Institute for Genetics, Health and Therapeutics, University of Leeds, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shona","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph K.","family":"Mwatha","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael N.","family":"Routledge","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Leeds Institute for Genetics, Health and Therapeutics, University of Leeds, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovita M.","family":"Castelino","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Leeds Institute for Genetics, Health and Therapeutics, University of Leeds, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Leeds Institute for Genetics, Health and Therapeutics, University of Leeds, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gachuhi","family":"Kimani","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Curtis","family":"Kariuki","sequence":"additional","affiliation":[{"name":"Division of Vector Borne Diseases, Ministry of Health, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte J.","family":"Vennervald","sequence":"additional","affiliation":[{"name":"DBL-Centre for Health Research and Development, Faculty of Life Science, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Dunne","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Wild","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2012,2,27]]},"reference":[{"key":"2026080507021604100_micit1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/0035-9203(92)90253-9","article-title":"Aflatoxin exposure, malaria and hepatitis-B infection in rural Gambian children.","volume":"86","author":"Allen","year":"1992","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2026080507021604100_micit2","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1289\/ehp.8384","article-title":"Case-control study of an acute aflatoxicosis outbreak, Kenya, 2004.","volume":"113","author":"Azziz-Baumgartner","year":"2005","journal-title":"Environ Health Perspect"},{"key":"2026080507021604100_micit3","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/1741-7015-2-36","article-title":"Exposure to malaria affects the regression of hepatosplenomegaly after treatment for Schistosoma mansoni infection in 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