{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:54:00Z","timestamp":1790477640824,"version":"4.1.0"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>DDT (Dichlorodiphenyltrichloroethane) is a synthetic organochlorine pesticide used in agriculture and mosquito control but later banned due to its harmful effects on humans. It persists in the environment, biomagnified through the food chain, and poses serious health risks, including reproductive defect, cancer, and nervous system disorders. DDT has a long half-life and potential of long-range transport and continuing to contaminate long after use and remains to pose a global environmental and health concern. Therefore, this review was designed to assess the concentration of DDT metabolites (p,p'-DDT, p,p'-DDD, and p,p'-DDE) in various food items and evaluate the health risk to consumers in the African.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The preferred reporting item for systematic reviews and meta-analysis (PRISMA) protocol was used to conduct this work. SCOPUS, PubMed, Web of Science, Google Scholar, DOAJ, national repository, and MedNar were used to retrieve articles from October 1, 2023, to January 20, 2024. Meta-analysis data visualized using a forest plot. A random-effects model was applied when heterogeneity existed in overall mean concentration of DDT metabolites. The subgroup analysis, meta-regression, and sensitivity analysis was conducted and the Joanna Briggs Institute Critical Assessment tool to assess the quality of the studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall mean concentrations of p,p'-DDT, p,p'-DDD and p,p'-DDE, regardless of the types of food items, were 0.188, 0.22, and 0.0878 mg\/kg, respectively. Based on the type of food items, The current study found that residue levels of DDT metabolites in vegetables, milk, and cereals exceeded the Maximum Residue Limits (MRLs) set by FAO\/WHO\/EU (0.05, 0.02, and 0.05 mg\/kg, respectively), while residue levels in meat, khat, and fruit were below the MRLs (5, 0.5, and 0.05 mg\/kg, respectively). The findings of the health risk assessment revealed that consumers are prone to both carcinogenic and non-carcinogenic risks from DDT metabolites. The persistence and bioaccumulation of these metabolites, along with multiple exposure routes and improper handling, may increase long-term health risks, even at low doses. DDT metabolite levels in most food categories exceed recommended limits, posing significant health risks to consumers. To reduce reliance on DDT, effective and cost-efficient alternative insecticides and vector-control strategies must be developed. Promoting environmental management, improving housing, and implementing farm-to-fork risk-based actions, such as Hazard Analysis and Critical Control Points (HACCP), across the food chain are crucial to mitigating the adverse effects of DDT exposure in the African region.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1511012","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T06:34:30Z","timestamp":1743575670000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Concentrations of DDT metabolites in different food items and public health risk in Africa regions: systematic review and metal analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Dechasa Adare","family":"Mengistu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Geremew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roba Argaw","family":"Tessema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Wolfing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1289\/ehp.1408273","article-title":"A review of non-occupational pathways for pesticide exposure in women living in agricultural areas","volume":"123","author":"Deziel","year":"2015","journal-title":"Environ Health Perspect."},{"key":"B2","unstructured":"2009\n          2017\n          \n          Geneva\n          The CODEX ALIMENTARIUS International Food Standard\n          Demonstrating Cost Effectiveness and Sustainability of Environmentally Sound and Locally Appropriate Alternatives to DDT for Malaria Vector Control in Africa\n          \n          2019"},{"key":"B3","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/978-3-031-50996-4_3","author":"Kumari","year":"2024","journal-title":"Dichlorodiphenyltrichloroethane (DDT). Emerging Contaminants and Associated Treatment Technologies Pollutants of Global Concern."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e0199904","DOI":"10.1371\/journal.pone.0199904","article-title":"Correction: prenatal and postnatal exposure to DDT by breast milk analysis in Canary Islands","volume":"13","author":"Vall","year":"2018","journal-title":"PLoS ONE"},{"key":"B5","unstructured":"Rome\n          CODEX ALIMENTARIUS International Food Standards. Pesticides Database. 2025\n          \n          2024"},{"key":"B6","volume-title":"Preventing Disease Through Healthy Environments: Exposure to Highly Hazardous Pesticides: A Major Public Health Concern","year":"2019"},{"key":"B7","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.chemosphere.2017.12.084","article-title":"Accumulation of organochlorine pesticides in fat tissue of wild Nile crocodiles (Crocodylus niloticus) from iSimangaliso Wetland Park, South Africa","volume":"195","author":"Buah-Kwofie","year":"2018","journal-title":"Chemosphere"},{"key":"B8","doi-asserted-by":"publisher","first-page":"128368","DOI":"10.1016\/j.chemosphere.2020.128368","article-title":"Levels of DDTs and other organochlorine pesticides in healthy wild Nile crocodiles (Crocodylus niloticus) from a flagship conservation area","volume":"264","author":"Gerber","year":"2021","journal-title":"Chemosphere"},{"key":"B9","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.jad.2017.05.002","article-title":"The global burden of fatal self-poisoning with pesticides 2006\u201315: systematic review","volume":"219","author":"Mew","year":"2017","journal-title":"J Affect Disord Sep."},{"key":"B10","unstructured":"Effects of DDT on environment and human health\n          \n          108\n          4\n          \n            \n              Thuy\n              TT\n            \n          \n          J Educ Soc Sci\n          2\n          2015"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1289\/ehp.11748","article-title":"The pine river statement: human health consequences of DDT use","volume":"117","author":"Eskenazi","year":"2009","journal-title":"Environ Health Perspect."},{"key":"B12","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/978-94-007-6461-3_16","article-title":"Pesticides mechanisms of action in living organisms","author":"Coman","year":"2013","journal-title":"Environmental Security Assessment and Management of Obsolete Pesticides in Southeast Europe. NATO Science for Peace and Security Series C: Environmental Security"},{"key":"B13","doi-asserted-by":"publisher","first-page":"11786302211072950","DOI":"10.1177\/11786302211072950","article-title":"Prevalence of pesticide use and occupational exposure among small-scale farmers in Western Ethiopia","volume":"16","author":"Afata","year":"2022","journal-title":"Environ Health Insights"},{"key":"B14","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1016\/j.spc.2020.11.019","article-title":"Understanding farmers' safety behavior regarding pesticide use in Morocco","volume":"25","author":"Berni","year":"2021","journal-title":"Sustain Prod Consum."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e0280185","DOI":"10.1371\/journal.pone.0280185","article-title":"Pesticide use safety practices and associated factors among farmers in Fogera district wetland areas, south Gondarzone, Northwest Ethiopia","volume":"18","author":"Alebachew","year":"2023","journal-title":"PLoS ONE"},{"key":"B16","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1111\/agec.12384","article-title":"Human health and pesticide use in sub-Saharan Africa","volume":"48","author":"Sheahan","year":"2017","journal-title":"Agric Econ."},{"key":"B17","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1111\/jdv.15964","article-title":"The association between pesticide use and cutaneous melanoma: a systematic review and meta-analysis","volume":"34","author":"Stanganelli","year":"2020","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"105113","DOI":"10.1016\/j.envint.2019.105113","article-title":"Association between intake of fruits and vegetables by pesticide residue status and coronary heart disease risk","volume":"132","author":"Chiu","year":"2019","journal-title":"Environ Int."},{"key":"B19","doi-asserted-by":"publisher","first-page":"117376","DOI":"10.1016\/j.envpol.2021.117376","article-title":"Exposure to pesticides and childhood leukemia risk: a systematic review and meta-analysis","volume":"285","author":"Karalexi","year":"2021","journal-title":"Environ Pollut"},{"key":"B20","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.envint.2016.02.013","article-title":"Exposure to pesticides and diabetes: a systematic review and meta-analysis","volume":"91","author":"Evangelou","year":"2016","journal-title":"Environ Int"},{"key":"B21","doi-asserted-by":"publisher","first-page":"129382","DOI":"10.1016\/j.chemosphere.2020.129382","article-title":"A global systematic review, meta-analysis and health risk assessment on the quantity of malathion, diazinon and chlorpyrifos in vegetables","volume":"270","author":"Kermani","year":"2021","journal-title":"Chemosphere"},{"key":"B22","unstructured":"Critical appraisal tools for use in the JBI systematic reviews checklist for prevalence studies: The University of Adelaide.\n          \n          2019"},{"key":"B23","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1177\/0272989X05282643","article-title":"The interpretation of random-effects meta-analysis in decision models","volume":"25","author":"Ades","year":"2005","journal-title":"Med Decis Making"},{"key":"B24","year":"1989","journal-title":"Risk Assessment Guidance for Superfund Volume I Human Health Evaluation Manual (Part A) Interim Final"},{"key":"B25","author":"Berhane","year":"2011","journal-title":"Foodgrain Consumption and Calorie Intake Patterns in Ethiopia. Development Strategy and Governance Division, International Food Policy Research Institute, Ethiopia Strategy Support Program II (ESSP II) ESSP II Working Paper No 23"},{"key":"B26","first-page":"369","year":"2012","journal-title":"Toxicological Profile for DDT, DDE, and DDD. Agency for Toxic Substances and Disease Registry and the U.S. Department of Health and Human Services."},{"key":"B27","doi-asserted-by":"publisher","first-page":"7503426","DOI":"10.1155\/2023\/7503426","article-title":"Pesticide residues and effect of household processing in commonly consumed vegetables in jimma zone, southwest Ethiopia","volume":"2023","author":"Terfe","year":"2023","journal-title":"J Environ Public Health."},{"key":"B28","doi-asserted-by":"publisher","first-page":"6612096","DOI":"10.1155\/2021\/6612096","article-title":"Determination of pesticide residues in food premises using QuECHERS method in Bench-Sheko Zone, Southwest Ethiopia","volume":"2021","author":"Mekonnen","year":"2021","journal-title":"Biomed Res Int"},{"key":"B29","doi-asserted-by":"publisher","first-page":"4331","DOI":"10.1002\/fsn3.3025","article-title":"Organochlorine pesticides residue affinity in fish muscle and their public health risks in North West Ethiopia","volume":"10","author":"Mitiku","year":"2022","journal-title":"Food Sci Nutr"},{"key":"B30","doi-asserted-by":"publisher","first-page":"44","DOI":"10.20372\/ejssdastu:v7.i1.2020.119","article-title":"Determination of residue levels of DDT and its metabolites in khat and cabbage samples using QuEChERS sample preparation method combined with GC-MS detection","volume":"7","author":"Regassa","year":"2020","journal-title":"Ethiop J Sci Sustain Dev."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1016\/j.chemosphere.2012.09.008","article-title":"Analysis of organochlorine pesticide residues in human and cow's milk in the towns of Asendabo, Serbo and Jimma in South-Western Ethiopia","volume":"90","author":"Gebremichael","year":"2013","journal-title":"Chemosphere."},{"key":"B32","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.chemosphere.2014.02.012","article-title":"Persistent organochlorine pesticides residues in cow and goat milks collected from different regions of Ethiopia","volume":"106","author":"Deti","year":"2014","journal-title":"Chemosphere"},{"key":"B33","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.envpol.2014.05.007","article-title":"Organochlorine pesticides in bird species and their prey (fish) from the Ethiopian Rift Valley region, Ethiopia","volume":"192","author":"Yohannes","year":"2014","journal-title":"Environ Pollut"},{"key":"B34","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.yrtph.2017.05.008","article-title":"Exposure to DDT and its metabolites from khat (Catha edulis) chewing: consumers risk assessment from southwestern Ethiopia","volume":"87","author":"Mekonen","year":"2017","journal-title":"Regul Toxicol Pharmacol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"33133","DOI":"10.1007\/s11356-021-12747-7","article-title":"Human health risk assessment of dichlorodiphenyltrichloroethane (DDT) and hexachlorocyclohexane (HCH) pesticide residues in fruits and vegetables in Nigeria","volume":"28","author":"Odewale","year":"2021","journal-title":"Environ Sci Pollut Res."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/leg3.3","article-title":"Organochlorine pesticide residue and heavy metals in leguminous food crops from selected markets in Ibadan, Nigeria","volume":"1","author":"Olutona","year":"2019","journal-title":"Legume Sci"},{"key":"B37","doi-asserted-by":"publisher","first-page":"442","DOI":"10.4314\/ijbcs.v9i1.38","article-title":"Dichloro-diphenyl-trichloro-ethane (DDT) and hexachlorohexane (HCH) pesticide residues in foodstuffs from markets in Ile-Ife, Nigeria","volume":"9","author":"Sosan","year":"2015","journal-title":"Int J Biol Chem Sci."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1016\/j.toxrep.2015.07.008","article-title":"Human health risks associated with residual pesticide levels in edible tissues of slaughtered cattle in Benin City, Southern Nigeria","volume":"2","author":"Tongo","year":"2015","journal-title":"Toxicol Rep"},{"key":"B39","doi-asserted-by":"publisher","first-page":"2658306","DOI":"10.1155\/2018\/2658306","article-title":"Levels of organochlorine pesticides in brackish water fish from Niger River, Nigeria","volume":"2018","author":"Unyimadu","year":"2018","journal-title":"J Environ Public Health"},{"key":"B40","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.chemosphere.2016.08.055","article-title":"Assessment of organochlorine pesticide residues in raw food samples from open markets in two African cities","volume":"164","author":"Nuapia","year":"2016","journal-title":"Chemosphere."},{"key":"B41","doi-asserted-by":"publisher","first-page":"332","DOI":"10.4236\/ajac.2016.74031","article-title":"Assessment of organochlorine pesticide residues in vegetable samples from some agricultural areas in Togo","volume":"7","author":"Kolani","year":"2016","journal-title":"American Journal of Analytical Chemistry."},{"key":"B42","doi-asserted-by":"publisher","first-page":"19","DOI":"10.12691\/ajfst-6-1-4","article-title":"Distribution of organochlorine pesticides residues in Solanum macrocarpum and Lactuca sativa cultivated in South of Benin (Cotonou and Seme-Kpodji)","volume":"6","author":"Agnandji","year":"2018","journal-title":"Am J Anal Chem."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40550-016-0028-4","article-title":"Persistent organochlorine pesticide residues in cocoa beans from Ghana, a concern for public health","volume":"3","author":"Okoffo","year":"2016","journal-title":"Int J Food Contam."},{"key":"B44","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jfca.2015.12.001","article-title":"Dietary exposure to chlorinated pesticide residues in fruits and vegetables from Ghanaian markets","volume":"46","author":"Bempah","year":"2016","journal-title":"J Food Compos Anal."},{"key":"B45","unstructured":"The Codex Alimentarius International Food Standards"},{"key":"B46","unstructured":"Commission Regulation (EU) 2023\/163 of 18 January 2023 amending Annexes II and III to Regulation (EC) No 396\/2005 of the European Parliament and of the Council as regards maximum residue levels for DDT and oxathiapiprolin in or on certain products (Text with EEA relevance).\n          \n          2023"},{"key":"B47","doi-asserted-by":"publisher","first-page":"113018","DOI":"10.1016\/j.envres.2022.113018","article-title":"Assessing the risk of diabetes in participants with DDT DDE exposure- a systematic review and meta-analysis","volume":"210","author":"Yipei","year":"2022","journal-title":"Environ Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1111\/j.1365-2826.2011.02229.x","article-title":"Endocrine disrupters: a review of some sources, effects, and mechanisms of actions on behaviour and neuroendocrine systems","volume":"24","author":"Frye","year":"2012","journal-title":"J Neuroendocrinol."},{"key":"B49","volume-title":"State of the Science of Endocrine Disrupting Chemicals 2012","author":"Bergman","year":"2013"},{"key":"B50","doi-asserted-by":"publisher","first-page":"210904","DOI":"10.5696\/2156-9614-11.31.210904","article-title":"Relationship between respiratory morbidity and environmental exposure to organochlorine pesticides in armenia","volume":"11","author":"Tadevosyan","year":"2021","journal-title":"Journal of Health Pollution."},{"key":"B51","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.ijheh.2013.07.012","article-title":"Association between serum levels of organochlorine pesticides and sex hormones in adults living in a heavily contaminated area in Brazil","volume":"217","author":"Freire","year":"2014","journal-title":"Int J Hyg Environ Health."},{"key":"B52","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1515\/reveh-2018-0018","article-title":"Exposure to persistent organic pollutants: impact on women's health","volume":"33","author":"Wahlang","year":"2018","journal-title":"Rev Environ Health."},{"key":"B53","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1001\/jamaneurol.2013.6030","article-title":"Elevated serum pesticide levels and risk for Alzheimer disease","volume":"71","author":"Richardson","year":"2014","journal-title":"JAMA Neurol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"A153","DOI":"10.1289\/ehp.11025R","article-title":"DDT and breast cancer: Cohn et al. respond","volume":"116","author":"Cohn","year":"2008","journal-title":"Environ Health Perspect"},{"key":"B55","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/S0140-6736(01)05329-6","article-title":"Association between maternal serum concentration of the DDT metabolite DDE and preterm and small-for-gestational-age babies at birth","volume":"358","author":"Longnecker","year":"2001","journal-title":"Lancet"},{"key":"B56","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1097\/00001648-200105000-00022","article-title":"DDT spraying for malaria control and reproductive function in mexican men","volume":"12","author":"Ayotte","year":"2001","journal-title":"Epidemiology"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1511012\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T06:35:21Z","timestamp":1743575721000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1511012\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,2]]},"references-count":56,"alternative-id":["10.3389\/fpubh.2025.1511012"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1511012","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,2]]},"article-number":"1511012"}}