{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T19:04:48Z","timestamp":1793387088304,"version":"4.5.0"},"reference-count":255,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Maize Trust","award":["MTM23-01"],"award-info":[{"award-number":["MTM23-01"]}]},{"name":"University of Johannesburg, South Africa","award":["MTM23-01"],"award-info":[{"award-number":["MTM23-01"]}],"id":[{"id":"https:\/\/ror.org\/04z6c2n17","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Aflatoxins (AFs), harmful secondary metabolites produced by the genus Aspergillus, particularly Aspergillus flavus and Aspergillus parasiticus, are one of the best-known potent mycotoxins, posing a significant risk to public health. The primary type, especially aflatoxin B1 (AFB1), is a potent carcinogen associated with liver cancer, immunosuppression, and other health problems. Environmental factors such as high temperatures, humidity, and inadequate storage conditions promote the formation of aflatoxin in staple foods such as maize, peanuts, and rice. Immunocompromised individuals, including those with HIV\/AIDS, hepatitis, cancer, or diabetes, are at increased risk due to their reduced detoxification capacity and weakened immune defenses. Chronic exposure to AF in these populations exacerbates liver damage, infection rates, and disease progression, particularly in developing countries and moderate-income populations where food safety regulations are inadequate and reliance on contaminated staple foods is widespread. Biomarkers such as aflatoxin-albumin complexes, urinary aflatoxin M1, and aflatoxin (AF) DNA adducts provide valuable insights but remain underutilized in resource-limited settings. Despite the globally recognized health risk posed by AF, research focused on monitoring human exposure remains limited, particularly among immunocompromised individuals. This dynamic emphasizes the need for targeted studies and interventions to address the particular risks faced by immunocompromised individuals. This review provides an up-to-date overview of AF exposure in immunocompromised populations, including individuals with cancer, hepatitis, diabetes, malnutrition, pregnant women, and the elderly. It also highlights exposure pathways, biomarkers, and biomonitoring strategies, while emphasizing the need for targeted interventions, advanced diagnostics, and policy frameworks to mitigate health risks in these vulnerable groups. Addressing these gaps is crucial to reducing the health burden and developing public health strategies in high-risk regions.<\/jats:p>","DOI":"10.3390\/toxins17080414","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T13:28:22Z","timestamp":1755523702000},"page":"414","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Aflatoxin Exposure in Immunocompromised Patients: Current State and Future Perspectives"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3343-7634","authenticated-orcid":false,"given":"Temitope R.","family":"Fagbohun","sequence":"first","affiliation":[{"name":"Department of Biotechnology and Food Technology, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-8916","authenticated-orcid":false,"given":"Queenta Ngum","family":"Nji","sequence":"additional","affiliation":[{"name":"Department of Biotechnology and Food Technology, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola O.","family":"Okechukwu","sequence":"additional","affiliation":[{"name":"Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Private Bag X680, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5125-4380","authenticated-orcid":false,"given":"Oluwasola A.","family":"Adelusi","sequence":"additional","affiliation":[{"name":"Department of Biotechnology and Food Technology, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1109-1094","authenticated-orcid":false,"given":"Lungani A.","family":"Nyathi","sequence":"additional","affiliation":[{"name":"Centre for Innovative Food Research (CIFR), Department of Biotechnology and Food Technology, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1388-3917","authenticated-orcid":false,"given":"Patience","family":"Awong","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5193-3650","authenticated-orcid":false,"given":"Patrick B.","family":"Njobeh","sequence":"additional","affiliation":[{"name":"Department of Biotechnology and Food Technology, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Adelusi, O.A., Gbashi, S., Adebo, J.A., Aasa, A.O., Oladeji, O.M., Kah, G., Adebo, O.A., Changwa, R., and Njobeh, P.B. (2023). Seasonal and geographical impact on the mycotoxigenicity of Aspergillus and Fusarium species isolated from smallholder dairy cattle feeds and feedstuffs in Free State and Limpopo provinces of South Africa. Toxins, 15.","DOI":"10.3390\/toxins15020128"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100197","DOI":"10.1016\/j.fochms.2024.100197","article-title":"Morphed aflaxotin concentration produced by Aspergillus flavus strain VKMN22 on maize grains inoculated on agar culture","volume":"8","author":"Okechukwu","year":"2024","journal-title":"Food Chem. Mol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Benkerroum, N. (2020). Chronic and acute toxicities of Aflatoxins: Mechanisms of action. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17020423"},{"key":"ref_4","unstructured":"Ramadan, N.A., and Al-Ameri, H.A. (2022). Aflatoxins, in Aflatoxins-Occurrence, Detoxification, Determination and Health Risks, IntechOpen."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1093\/jee\/toae074","article-title":"Preharvest insect pests of peanuts and associated aflatoxin contaminants in Georgia, USA","volume":"117","author":"Danso","year":"2024","journal-title":"J. Econ. Entomol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Aminou, M.M., Falalou, H., Abdou, H., and Mendu, V. (2024). Aflatoxin B1 Contamination Association with the Seed Coat Biochemical Marker Polyphenol in Peanuts Under Intermittent Drought. J. Fungi, 10.","DOI":"10.3390\/jof10120850"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Muaz, K., Manzoor, S., Akhtar, S., Riaz, M., Amir, M., Akram, K., and Ismail, A. (2022). Aflatoxin Biosynthesis. Aflatoxins in Food: A Recent Perspective, Springer.","DOI":"10.1007\/978-3-030-85762-2_2"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"137775","DOI":"10.1016\/j.foodchem.2023.137775","article-title":"Aflatoxins: Occurrence, biosynthesis, mechanism of action and effects, conventional\/emerging detection techniques","volume":"436","author":"Okechukwu","year":"2024","journal-title":"Food Chem."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1080\/19393210.2024.2351575","article-title":"Aflatoxins in maize and groundnuts on markets in Accra and consumers risk","volume":"17","author":"Boadu","year":"2024","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1080\/19393210.2024.2335656","article-title":"Aflatoxins in maize, milk and dairy products from Serbia","volume":"17","author":"Kos","year":"2024","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Falade, T.D., Neya, A., Bonkoungou, S., Dagno, K., Basso, A., Senghor, A.L., Atehnkeng, J., Ortega-Beltran, A., and Bandyopadhyay, R. (2022). Aflatoxin contamination of maize, groundnut, and sorghum grown in Burkina Faso, Mali, and Niger and aflatoxin exposure assessment. Toxins, 14.","DOI":"10.3390\/toxins14100700"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wenndt, A., Sudini, H.K., Pingali, P., and Nelson, R. (2020). Exploring aflatoxin contamination and household-level exposure risk in diverse Indian food systems. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0240565"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Xia, L., Routledge, M.N., Rasheed, H., Ismail, A., Dong, Y., Jiang, T., and Gong, Y.Y. (2020). Biomonitoring of aflatoxin B1 and deoxynivalenol in a rural pakistan population using ultra-sensitive LC-MS\/MS method. Toxins, 12.","DOI":"10.3390\/toxins12090591"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"9395","DOI":"10.1080\/03067319.2021.2011254","article-title":"Occurrence, dietary exposure, and risk assessment of Aflatoxins in wheat flour from Iran","volume":"103","author":"Heshmati","year":"2023","journal-title":"Int. J. Environ. Anal. Chem."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"106738","DOI":"10.1016\/j.foodcont.2019.106738","article-title":"Multimycotoxin LC-MS\/MS analysis in pearl millet (Pennisetum glaucum) from Tunisia","volume":"106","author":"Houissa","year":"2019","journal-title":"Food Control"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107386","DOI":"10.1016\/j.foodcont.2020.107386","article-title":"Aflatoxin M1 in milk and milk products marketed by local and industrial producers in Bishoftu town of Ethiopia","volume":"118","author":"Tadesse","year":"2020","journal-title":"Food Control"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s12281-024-00496-2","article-title":"Assessing Aflatoxin Exposure: Exploring Types of Exposure and Diverse Biomarkers\u2014A Minireview","volume":"18","author":"Mathew","year":"2024","journal-title":"Curr. Fungal Infect. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1080\/15376516.2021.2021339","article-title":"Aflatoxin B1: Metabolism, toxicology, and its involvement in oxidative stress and cancer development","volume":"32","author":"Cao","year":"2022","journal-title":"Toxicol. Mech. Methods"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1080\/19440049.2020.1825825","article-title":"Nutrition and growth outcomes are affected by aflatoxin exposures in Kenyan children","volume":"37","author":"Xue","year":"2020","journal-title":"Food Addit. Contam. Part A"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s12550-021-00431-1","article-title":"An overview on possible links between aflatoxin B1 exposure and gallbladder cancer","volume":"37","author":"Costa","year":"2021","journal-title":"Mycotoxin Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13027-018-0214-5","article-title":"Risk factors for liver Cancer in HIV endemic areas of Western Kenya","volume":"13","author":"Otedo","year":"2018","journal-title":"Infect. Agents Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"103734","DOI":"10.1016\/j.jfca.2020.103734","article-title":"Aflatoxins in foodstuffs: Occurrence and risk assessment in Turkey","volume":"96","author":"Kabak","year":"2021","journal-title":"J. Food Compos. Anal."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"62907","DOI":"10.1007\/s11356-021-14871-w","article-title":"Biochemical investigation of human exposure to aflatoxin M1 and its association with risk factors of diabetes mellitus","volume":"28","author":"Akash","year":"2021","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"9955","DOI":"10.1080\/10408398.2023.2219336","article-title":"Effects of aflatoxin on the immune system: Evidence from human and mammalian animal research","volume":"64","author":"Comstock","year":"2024","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1002\/ijc.30782","article-title":"Aflatoxin B1 exposure increases the risk of cirrhosis and hepatocellular carcinoma in chronic hepatitis B virus carriers","volume":"141","author":"Chu","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1152\/physrev.00039.2018","article-title":"Pathogenesis of HIV-related lung disease: Immunity, infection, and inflammation","volume":"100","author":"Cribbs","year":"2020","journal-title":"Physiol. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"553","DOI":"10.3920\/WMJ2020.2646","article-title":"Aflatoxin contamination in Tanzania: Quantifying the problem in maize and groundnuts from rural households","volume":"14","author":"Boni","year":"2021","journal-title":"World Mycotoxin J."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Rasheed, H., Xu, Y., Kimanya, M.E., Pan, X., Li, Z., Zou, X., Shirima, C.P., Holmes, M., Routledge, M.N., and Gong, Y.Y. (2021). Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa. Sci. Rep., 11.","DOI":"10.1038\/s41598-020-80356-4"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1007\/s11904-022-00630-0","article-title":"Telehealth interventions for HIV in low-and middle-income countries","volume":"19","author":"Phan","year":"2022","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s12550-019-00383-7","article-title":"Preliminary study on the relationship between aflatoxin-bovine serum albumin adducts in blood and aflatoxin M1 levels in milk of dairy cows","volume":"36","author":"Saltzmann","year":"2020","journal-title":"Mycotoxin Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"30583","DOI":"10.1007\/s11356-020-09361-4","article-title":"Evaluation of acute and chronic exposure to aflatoxin B1 in indigenous women of the Huasteca Potosina, Mexico","volume":"27","year":"2020","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Autrup, H., and Autrup, J.L. (2024). Human exposure to aflatoxins-biological monitoring. Handbook of Applied Mycology, CRC Press.","DOI":"10.1201\/9781003573807-8"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"107672","DOI":"10.1016\/j.foodcont.2020.107672","article-title":"Aflatoxin contamination: Knowledge disparities among agriculture extension officers, frontline health workers and small holder farming households in Malawi","volume":"121","author":"Kumwenda","year":"2021","journal-title":"Food Control"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.tifs.2020.11.001","article-title":"Novel decontamination approaches and their potential application for post-harvest aflatoxin control","volume":"106","author":"Marshall","year":"2020","journal-title":"Trends Food Sci. Technol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Shabeer, S., Asad, S., Jamal, A., and Ali, A. (2022). Aflatoxin contamination, its impact and management strategies: An updated review. Toxins, 14.","DOI":"10.3390\/toxins14050307"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2400033","DOI":"10.1002\/adtp.202400033","article-title":"Latest Progress on Tuberculosis and HIV Co-Infection: A Closer Look at People of Different Ages","volume":"8","author":"Adeleke","year":"2025","journal-title":"Adv. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.ocsci.2020.11.001","article-title":"A review on biosynthesis and genetic regulation of aflatoxin production by major Aspergillus fungi","volume":"5","author":"Liao","year":"2020","journal-title":"Oil Crop Sci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ma, L., Li, X., Xing, F., Ma, J., Ma, X., and Jiang, Y. (2022). Fus3, as a critical kinase in MAPK cascade, regulates aflatoxin biosynthesis by controlling the substrate supply in Aspergillus flavus, rather than the cluster genes modulation. Microbiol. Spectr., 10.","DOI":"10.1128\/spectrum.01269-21"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1111\/1462-2920.16034","article-title":"Post-translational modifications drive secondary metabolite biosynthesis in Aspergillus: A review","volume":"24","author":"Yang","year":"2022","journal-title":"Environ. Microbiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1039\/D2NP00005A","article-title":"Plant biosynthetic gene clusters in the context of metabolic evolution","volume":"39","author":"Smit","year":"2022","journal-title":"Nat. Prod. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1080\/17565529.2021.1951644","article-title":"Climate change risks to human development in sub-Saharan Africa: A review of the literature","volume":"14","author":"Dickerson","year":"2022","journal-title":"Clim. Dev."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Awuchi, C.G., Ondari, E.N., Ogbonna, C.U., Upadhyay, A.K., Baran, K., Okpala, C.O.R., Korzeniowska, M., and Guin\u00e9, R.P. (2021). Mycotoxins affecting animals, foods, humans, and plants: Types, occurrence, toxicities, action mechanisms, prevention, and detoxification strategies\u2014A revisit. Foods, 10.","DOI":"10.3390\/foods10061279"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Ashby, E., Nicholson, A., and Haag, T. (2023). The Role of Plant Agricultural Practices on Development of Antimicrobial Resistant Fungi Affecting Human Health, National Academies Press.","DOI":"10.17226\/26833"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Marchante, H., Palhas, J., N\u00fa\u00f1ez, F.A.L., and Marchante, E. (2021). Invasive species impacts and management. Life on Land, Springer.","DOI":"10.1007\/978-3-319-95981-8_85"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Nji, Q.N., Babalola, O.O., Ekwomadu, T.I., Nleya, N., and Mwanza, M. (2022). Six Main Contributing Factors to High Levels of Mycotoxin Contamination in African Foods. Toxins, 14.","DOI":"10.3390\/toxins14050318"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1002\/9781119742975.ch6","article-title":"Risk characterization","volume":"Volume 1","author":"Williams","year":"2024","journal-title":"Human and Ecological Risk Assessment: Theory and Practice"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Kibugu, J., Munga, L., Mburu, D., Maloba, F., Auma, J.E., Grace, D., and Lindahl, J.F. (2024). Dietary mycotoxins: An overview on toxicokinetics, toxicodynamics, toxicity, epidemiology, detection, and their mitigation with special emphasis on aflatoxicosis in humans and animals. Toxins, 16.","DOI":"10.3390\/toxins16110483"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Moffett, D.B., Mumtaz, M.M., Sullivan, D.W., and Whittaker, M.H. (2022). General considerations of dose-effect and dose-response relationships. Handbook on the Toxicology of Metals, Academic Press.","DOI":"10.1016\/B978-0-12-823292-7.00019-X"},{"key":"ref_49","unstructured":"FAO\/WHO (2015). Joint FAO\/WHO Food Standards Programme Codex Committee on Contaminants in Foods, WHO. WHO, Geneva 9th Session."},{"key":"ref_50","first-page":"353","article-title":"Mycotoxins: The threat to food safety","volume":"65","author":"Marrez","year":"2022","journal-title":"Egypt. J. Chem."},{"key":"ref_51","first-page":"1196","article-title":"Human Exposure to Mycotoxins: A Retrospective Review of Leading Toxins and Metabolites in Human Biological Matrices","volume":"36","author":"Waseem","year":"2014","journal-title":"J. Chem. Soc. Pak."},{"key":"ref_52","unstructured":"(2025, March 25). Partnership for Aflatoxin Control in Africa (PACA) Secretariat, PACA Strategy: Overview of Intervention and Results. African Union Commission. Available online: https:\/\/archives.au.int\/handle\/123456789\/5549."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.foodcont.2016.05.029","article-title":"Technological and community-based methods to reduce mycotoxin exposure","volume":"73","author":"Alberts","year":"2017","journal-title":"Food Control"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jef.2017.08.001","article-title":"Traditional fermented foods and beverages of Namibia","volume":"4","author":"Misihairabgwi","year":"2017","journal-title":"J. Ethn. Foods"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Zebib, H., Abate, D., and Woldegiorgis, A.Z. (2022). Aflatoxin M1 in raw milk, pasteurized milk and cottage cheese collected along value chain actors from three regions of Ethiopia. Toxins, 14.","DOI":"10.3390\/toxins14040276"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.fbr.2017.04.002","article-title":"Climate change, food security and mycotoxins: Do we know enough?","volume":"31","author":"Medina","year":"2017","journal-title":"Fungal Biol. Rev."},{"key":"ref_57","first-page":"1881E","article-title":"Climate change as a driver of emerging risks for food and feed safety, plant, animal health and nutritional quality","volume":"17","author":"Authority","year":"2020","journal-title":"EFSA Support. Publ."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.foodchem.2017.06.088","article-title":"Assessment of multiple mycotoxins in breakfast cereals available in the Portuguese market","volume":"239","author":"Martins","year":"2018","journal-title":"Food Chem."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Akello, J., Ortega-Beltran, A., Katati, B., Atehnkeng, J., Augusto, J., Mwila, C.M., Mahuku, G., Chikoye, D., and Bandyopadhyay, R. (2021). Prevalence of aflatoxin-and fumonisin-producing fungi associated with cereal crops grown in Zimbabwe and their associated risks in a climate change scenario. Foods, 10.","DOI":"10.3390\/foods10020287"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Agriopoulou, S., Stamatelopoulou, E., and Varzakas, T. (2020). Advances in analysis and detection of major mycotoxins in foods. Foods, 9.","DOI":"10.3390\/foods9040518"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1080\/19393210.2015.1121928","article-title":"Mycotoxin contamination of home-grown maize in rural northern South Africa (Limpopo and Mpumalanga Provinces)","volume":"9","author":"Mngqawa","year":"2016","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.toxrep.2019.05.011","article-title":"Comparative study of aflatoxin contamination of winter and summer ginger from the North West Province of South Africa","volume":"6","author":"Omotayo","year":"2019","journal-title":"Toxicol. Rep."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ijfoodmicro.2018.02.001","article-title":"Mycobiota and co-occurrence of mycotoxins in South African maize-based opaque beer","volume":"270","author":"Adekoya","year":"2018","journal-title":"Int. J. Food Microbiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1080\/02652030110053426","article-title":"Mycotoxins in South African traditionally brewed beers","volume":"19","author":"Odhav","year":"2002","journal-title":"Food Addit. Contam."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.5897\/AJMR2017.8606","article-title":"Susceptibility of locally cultivated groundnut (Arachis hypogaea) varieties to aflatoxin accumulation in Homa Bay County, Kenya","volume":"11","author":"Ndisio","year":"2017","journal-title":"Afr. J. Microbiol. Res."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Dada, T.A., Ekwomadu, T.I., and Mwanza, M. (2020). Multi-mycotoxin determination in dried beef using liquid chromatography coupled with triple quadrupole mass spectrometry (LC-MS\/MS). Toxins, 12.","DOI":"10.3390\/toxins12060357"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"107055","DOI":"10.1016\/j.foodcont.2019.107055","article-title":"Occurrence of aflatoxin M1 in raw, pasteurized, UHT cows\u2019 milk, and dairy products in Lebanon","volume":"111","author":"Daou","year":"2020","journal-title":"Food Control"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Ekpakpale, D.O., Kraak, B., Meijer, M., Ayeni, K.I., Houbraken, J., and Ezekiel, C.N. (2021). Fungal diversity and Aflatoxins in maize and rice grains and cassava-based flour (Pupuru) from Ondo State, Nigeria. J. Fungi, 7.","DOI":"10.3390\/jof7080635"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/19393210.2019.1690590","article-title":"Fungi and mycotoxins in cowpea (Vigna unguiculata L.) on Nigerian markets","volume":"13","author":"Afolabi","year":"2020","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_70","first-page":"e00188","article-title":"Occurrence of major mycotoxins and their dietary exposure in North-Central Nigeria staples","volume":"7","author":"Onyedum","year":"2020","journal-title":"Sci. Afr."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.foodcont.2017.04.015","article-title":"The seasonal variation of aflatoxin M1 in milk and dairy products and assessment of dietary intake in Punjab, Pakistan","volume":"79","author":"Iqbal","year":"2017","journal-title":"Food Control"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1080\/19440049.2017.1331047","article-title":"Aflatoxins contamination of maize in Serbia: The impact of weather conditions in 2015","volume":"34","author":"Hajnal","year":"2017","journal-title":"Food Addit. Contam. Part A"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1080\/19393210.2018.1499675","article-title":"Aflatoxins in maize harvested in the Republic of Serbia over the period 2012\u20132016","volume":"11","author":"Kos","year":"2018","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12550-015-0237-3","article-title":"Knowledge, attitude, and practices concerning presence of molds in foods among members of the general public in Malawi","volume":"32","author":"Matumba","year":"2016","journal-title":"Mycotoxin Res."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1","DOI":"10.17159\/sajs.2019\/6221","article-title":"Agricultural practices and their potential role in mycotoxin contamination of maize and groundnut subsistence farming","volume":"115","author":"Phokane","year":"2019","journal-title":"S. Afr. J. Sci."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Nji, Q.N., Babalola, O.O., Nleya, N., and Mwanza, M. (2022). Underreported human exposure to mycotoxins: The case of South Africa. Foods, 11.","DOI":"10.3390\/foods11172714"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Jiang, Y., Ogunade, I.M., Vyas, D., and Adesogan, A.T. (2021). Aflatoxin in dairy cows: Toxicity, occurrence in feedstuffs and milk and dietary mitigation strategies. Toxins, 13.","DOI":"10.3390\/toxins13040283"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Smaoui, S., D\u2019Amore, T., Tarapoulouzi, M., Agriopoulou, S., and Varzakas, T. (2023). Aflatoxins contamination in feed commodities: From occurrence and toxicity to recent advances in analytical methods and detoxification. Microorganisms, 11.","DOI":"10.3390\/microorganisms11102614"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Zhao, W., Abdelsattar, M.M., Wang, X., Zhang, N., and Chai, J. (2023). In vitro modulation of rumen fermentation by microbiota from the recombination of rumen fluid and solid phases. Microbiol. Spectr., 11.","DOI":"10.1128\/spectrum.03387-22"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Fink-Gremmels, J., and van der Merwe, D. (2019). Mycotoxins in the food chain: Contamination of foods of animal origin. Chemical Hazards in Foods of Animal Origin, Wageningen Academic.","DOI":"10.3920\/978-90-8686-877-3_10"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.fm.2018.09.014","article-title":"Fungal mycobiota and mycotoxin risk for traditional artisan Italian cave cheese","volume":"78","author":"Anelli","year":"2019","journal-title":"Food Microbiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"114","DOI":"10.14737\/journal.aavs\/2016\/4.2.114.121","article-title":"Determination of aflatoxin M1 and ochratoxin A in milk and dairy products in supermarkets located in Mansoura City, Egypt","volume":"4","author":"Younis","year":"2016","journal-title":"Adv. Anim. Vet. Sci."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Mwihia, E.W., Mbuthia, P.G., Eriksen, G.S., Gathumbi, J.K., Maina, J.G., Mutoloki, S., Waruiru, R.M., Mulei, I.R., and Lyche, J.L. (2018). Occurrence and Levels of Aflatoxins in Fish Feeds and Their Potential Effects on Fish in Nyeri, Kenya. Toxins, 10.","DOI":"10.3390\/toxins10120543"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Namulawa, V.T., Mutiga, S., Musimbi, F., Akello, S., Ng\u00e1ng\u00e1, F., Kago, L., Kyallo, M., Harvey, J., and Ghimire, S. (2020). Assessment of fungal contamination in fish feed from the Lake Victoria Basin, Uganda. Toxins, 12.","DOI":"10.3390\/toxins12040233"},{"key":"ref_85","first-page":"31","article-title":"Risk assessment of aflatoxin and fumonisin in fish feeds, Kenya a review","volume":"11","author":"Chelimo","year":"2021","journal-title":"Risk"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/jwas.12371","article-title":"Impact of mycotoxins on aquaculture fish species: A review","volume":"48","author":"Matejova","year":"2017","journal-title":"J. World Aquac. Soc."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Triarico, S., Rivetti, S., Capozza, M.A., Romano, A., Maurizi, P., Mastrangelo, S., Attin\u00e0, G., and Ruggiero, A. (2022). Transplacental passage and fetal effects of antineoplastic treatment during pregnancy. Cancers, 14.","DOI":"10.3390\/cancers14133103"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/mcn.12155","article-title":"Risk of dietary exposure to Aflatoxins and fumonisins in infants less than 6 months of age in Rombo, Northern Tanzania","volume":"12","author":"Magoha","year":"2016","journal-title":"Matern. Child Nutr."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s10995-008-0439-9","article-title":"Determination of Aflatoxin M1 in breast milk samples in Tabriz\u2013Iran","volume":"14","author":"Mahdavi","year":"2010","journal-title":"Matern. Child Health J."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Benkerroum, N., and Ismail, A. (2022). Human breast milk contamination with Aflatoxins, impact on children\u2019s health, and possible control means: A review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192416792"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"471","DOI":"10.12944\/CRNFSJ.12.2.1","article-title":"Dietary Exposure of Infants and Young Children to Aflatoxins and Fumonisins in the East African Region: A Review","volume":"12","author":"Kayanda","year":"2024","journal-title":"Curr. Res. Nutr. Food Sci. J."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Viegas, S., Assun\u00e7\u00e3o, R., Martins, C., Nunes, C., Osteresch, B., Twaru\u017cek, M., Kosicki, R., Grajewski, J., Ribeiro, E., and Viegas, C. (2019). Occupational exposure to mycotoxins in swine production: Environmental and biological monitoring approaches. Toxins, 11.","DOI":"10.3390\/toxins11020078"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1002\/jsfa.10120","article-title":"Mycotoxins feed contamination in a dairy farm\u2013potential implications for milk contamination and workers\u2019 exposure in a One Health approach","volume":"100","author":"Viegas","year":"2020","journal-title":"J. Sci. Food Agric."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Viegas, S., Assun\u00e7\u00e3o, R., Nunes, C., Osteresch, B., Twaru\u017cek, M., Kosicki, R., Grajewski, J., Martins, C., Alvito, P., and Almeida, A. (2018). Exposure assessment to mycotoxins in a Portuguese fresh bread dough company by using a multi-biomarker approach. Toxins, 10.","DOI":"10.3390\/toxins10090342"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1093\/annweh\/wxy070","article-title":"Occupational exposure to mycotoxins: Current knowledge and prospects","volume":"62","author":"Viegas","year":"2018","journal-title":"Ann. Work. Expo. Health"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Cramer, B., and Humpf, H.-U. (2017). Human biomonitoring of mycotoxins for the detection of nutritional, environmental and occupational exposure. Exposure to Microbiological Agents in Indoor and Occupational Environments, Springer.","DOI":"10.1007\/978-3-319-61688-9_9"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"155763","DOI":"10.1016\/j.scitotenv.2022.155763","article-title":"Assessment of occupational and dietary exposures of feed handling workers to mycotoxins in rural areas from S\u00e3o Paulo, Brazil","volume":"837","author":"Franco","year":"2022","journal-title":"Sci. Total Environ."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Huttunen, K., and Korkalainen, M. (2017). Microbial secondary metabolites and knowledge on inhalation effects. Exposure to Microbiological Agents in Indoor and Occupational Environments, Springer.","DOI":"10.1007\/978-3-319-61688-9_10"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.tox.2014.03.004","article-title":"In vivo treatment with aflatoxin B1 increases DNA oxidation, base excision repair activity and 8-oxoguanine DNA glycosylase 1 levels in mouse lung","volume":"321","author":"Mulder","year":"2014","journal-title":"Toxicology"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1093\/annhyg\/mev077","article-title":"Occupational exposure to Aflatoxin B1 in a Portuguese poultry slaughterhouse","volume":"60","author":"Viegas","year":"2016","journal-title":"Ann. Occup. Hyg."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"645","DOI":"10.2131\/jts.39.645","article-title":"How does airway exposure of aflatoxin B1 affect serum albumin adduct concentrations? Evidence based on epidemiological study and animal experimentation","volume":"39","author":"Mo","year":"2014","journal-title":"J. Toxicol. Sci."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"9577","DOI":"10.1007\/s13277-014-2231-3","article-title":"Association between aflatoxin B1 occupational airway exposure and risk of hepatocellular carcinoma: A case-control study","volume":"35","author":"Lai","year":"2014","journal-title":"Tumor Biol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0026-265X(02)00061-9","article-title":"Exposure assessment to mycotoxins in workplaces: Aflatoxins and Ochratoxin A occurrence in airborne dusts and human sera","volume":"73","author":"Brera","year":"2002","journal-title":"Microchem. J."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1080\/15428119891010514","article-title":"Assessing airborne aflatoxin B1 during on-farm grain handling activities","volume":"59","author":"Selim","year":"1998","journal-title":"Am. Ind. Hyg. Assoc. J."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"436","DOI":"10.5271\/sjweh.1683","article-title":"Determination of exposure to Aflatoxins among Danish workers in animal-feed production through the analysis of aflatoxin B1 adducts to serum albumin","volume":"17","author":"Autrup","year":"1991","journal-title":"Scand. J. Work Environ. Health"},{"key":"ref_106","first-page":"173","article-title":"Assessment of workers\u2019 exposure to aflatoxin B1 in a Portuguese waste industry","volume":"59","author":"Viegas","year":"2015","journal-title":"Ann. Occup. Hyg."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1080\/15287394.2012.721164","article-title":"Occupational exposure to aflatoxin (AFB1) in poultry production","volume":"75","author":"Viegas","year":"2012","journal-title":"J. Toxicol. Environ. Health Part A"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1002\/ajim.22162","article-title":"Effect of occupational exposure to Aflatoxins on some liver tumor markers in textile workers","volume":"56","author":"Beshir","year":"2013","journal-title":"Am. J. Ind. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s12550-017-0302-1","article-title":"Enniatin B and Ochratoxin A in the blood serum of workers from the waste management setting","volume":"34","author":"Viegas","year":"2018","journal-title":"Mycotoxin Res."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3920\/WMJ2012.1399","article-title":"Occupational aflatoxin exposure among feed mill workers in Nigeria","volume":"5","author":"Oluwafemi","year":"2012","journal-title":"World Mycotoxin J."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/10590501.2019.1664836","article-title":"Occupational exposure to Aflatoxins and health outcomes: A review","volume":"37","author":"Wangia","year":"2019","journal-title":"J. Environ. Sci. Health Part C"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1038\/jes.2015.10","article-title":"Human skin permeation of emerging mycotoxins (Beauvericin and Enniatins)","volume":"26","author":"Taevernier","year":"2016","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"113013","DOI":"10.1016\/j.fct.2022.113013","article-title":"Mycotoxins in raw materials, beverages and supplements of botanicals: A review of occurrence, risk assessment and analytical methodologies","volume":"165","author":"Pallares","year":"2022","journal-title":"Food Chem. Toxicol."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Carballo, D., Fern\u00e1ndez-Franz\u00f3n, M., Ferrer, E., Pallar\u00e9s, N., and Berrada, H. (2021). Dietary exposure to mycotoxins through alcoholic and non-alcoholic beverages in Valencia, Spain. Toxins, 13.","DOI":"10.3390\/toxins13070438"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.envpol.2019.02.091","article-title":"Determination of multiple mycotoxins in paired plasma and urine samples to assess human exposure in Nanjing, China","volume":"248","author":"Fan","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.tifs.2022.11.013","article-title":"Emerging strategies in fluorescent aptasensor toward food hazard Aflatoxins detection","volume":"129","author":"Zhang","year":"2022","journal-title":"Trends Food Sci. Technol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1093\/carcin\/13.5.891","article-title":"Aflatoxrn M1 in human breast milk from The Gambia, West Africa, quantified by combined monoclonal antibody immunoaffinity chromatography and HPLC","volume":"13","author":"Zarba","year":"1992","journal-title":"Carcinogenesis"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/carcin\/bgp264","article-title":"Mycotoxins and human disease: A largely ignored global health issue","volume":"31","author":"Wild","year":"2010","journal-title":"Carcinogenesis"},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Mamo, F.T., Abate, B.A., Zheng, Y., Nie, C., He, M., and Liu, Y. (2021). Distribution of Aspergillus fungi and recent aflatoxin reports, health risks, and advances in developments of biological mitigation strategies in China. Toxins, 13.","DOI":"10.3390\/toxins13100678"},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Escriv\u00e1, L., Font, G., Manyes, L., and Berrada, H. (2017). Studies on the presence of mycotoxins in biological samples: An overview. Toxins, 9.","DOI":"10.3390\/toxins9080251"},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Vallero, D.A. (2017). Translating Diverse Environmental Data into Reliable Information: How to Coordinate Evidence from Different Sources, Academic Press.","DOI":"10.1016\/B978-0-12-812446-8.00009-8"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s10654-020-00618-3","article-title":"Environmental factors, serum biomarkers and risk of atrial fibrillation: An exposure-wide umbrella review of meta-analyses","volume":"35","author":"Belbasis","year":"2020","journal-title":"Eur. J. Epidemiol."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Filipoiu, D.C., Bungau, S.G., Endres, L., Negru, P.A., Bungau, A.F., Pasca, B., Radu, A.-F., Tarce, A.G., Bogdan, M.A., and Behl, T. (2022). Characterization of the toxicological impact of heavy metals on human health in conjunction with modern analytical methods. Toxics, 10.","DOI":"10.3390\/toxics10120716"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.2174\/1568026622666221006140825","article-title":"Artificial Intelligence Approaches in Drug Discovery: Towards the Laboratory of the Future","volume":"22","author":"Frusciante","year":"2022","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Quig, D. (2020). Metal toxicity: Assessment of exposure and retention. Textbook of Natural Medicine, Elsevier.","DOI":"10.1016\/B978-0-323-43044-9.00022-4"},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Habschied, K., Kani\u017eai \u0160ari\u0107, G., Krstanovi\u0107, V., and Mastanjevi\u0107, K. (2021). Mycotoxins\u2014Biomonitoring and human exposure. Toxins, 13.","DOI":"10.3390\/toxins13020113"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"121404","DOI":"10.1016\/j.talanta.2020.121404","article-title":"Silver and gold nanoparticles characterization by SP-ICP-MS and AF4-FFF-MALS-UV-ICP-MS in human samples used for biomonitoring","volume":"220","author":"Bocca","year":"2020","journal-title":"Talanta"},{"key":"ref_128","first-page":"116","article-title":"A focus on Aflatoxins in feedstuffs: Levels of contamination, prevalence, control strategies, and impacts on animal health","volume":"2017","author":"Alvarado","year":"2017","journal-title":"Aflatoxin-Control. Anal. Detect. Health Risks"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"100344","DOI":"10.1016\/j.cotox.2022.03.005","article-title":"Endogenous markers of kidney function and renal drug clearance processes of filtration, secretion, and reabsorption","volume":"31","author":"Thompson","year":"2022","journal-title":"Curr. Opin. Toxicol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s12403-023-00595-4","article-title":"Applications of mycotoxin biomarkers in human biomonitoring for exposome-health studies: Past, present, and future","volume":"16","author":"Owolabi","year":"2024","journal-title":"Expo. Health"},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Arce-L\u00f3pez, B., Lizarraga, E., Vettorazzi, A., and Gonz\u00e1lez-Pe\u00f1as, E. (2020). Human biomonitoring of mycotoxins in blood, plasma and serum in recent years: A review. Toxins, 12.","DOI":"10.3390\/toxins12030147"},{"key":"ref_132","unstructured":"Bore, M.G. (2025, April 29). Nutritional Status Among Adolescents Living with Human Immuno-Deficiency Virus on Anti-Retroviral Therapy Follow-Up Living in Selected Regions of Ethiopia: A Mixed Methods Study. Available online: http:\/\/hdl.handle.net\/10453\/187481."},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Wobudeya, E., Bonnet, M., Walters, E.G., Nabeta, P., Song, R., Murithi, W., Mchembere, W., Dim, B., Taguebue, J.-V., and Orne-Gliemann, J. (2022). Diagnostic advances in childhood tuberculosis\u2014Improving specimen collection and yield of microbiological diagnosis for intrathoracic tuberculosis. Pathogens, 11.","DOI":"10.3390\/pathogens11040389"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"104644","DOI":"10.1016\/j.etap.2025.104644","article-title":"Assessing Aflatoxin Exposure in the United Arab Emirates (UAE): Biomonitoring AFM1 levels in Urine Samples and their Association with Dietary Habits","volume":"114","author":"Elabed","year":"2025","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"107863","DOI":"10.1016\/j.foodcont.2021.107863","article-title":"Assessment of Aflatoxins exposure through urinary biomarker approach and the evaluation of the impacts of Aflatoxins exposure on the selected health parameters of the children of Multan city of Pakistan","volume":"123","author":"Nasir","year":"2021","journal-title":"Food Control"},{"key":"ref_136","unstructured":"Kuempel, E.D., Roberts, J.R., Roth, G., Dunn Kevin, L., Zumwalde, R.D., Hubbs, A.F., Trout, D., and Holdsworth, G. (2025, April 29). Health Effects of Occupational Exposure to Silver Nanomaterials, Available online: https:\/\/www.cdc.gov\/niosh\/docs\/2021-112\/default.html."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.2174\/1568026619666190828161409","article-title":"Mechanisms of protective effects of SGLT2 inhibitors in cardiovascular disease and renal dysfunction","volume":"19","author":"Liu","year":"2019","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_138","first-page":"e06040","article-title":"Risk assessment of aflatoxins in food","volume":"18","author":"Panel","year":"2020","journal-title":"EFSA J."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"110994","DOI":"10.1016\/j.fct.2019.110994","article-title":"LC-MS\/MS methodology for simultaneous determination of patulin and citrinin in urine and plasma applied to a pilot study in colorectal cancer patients","volume":"136","author":"Ouhibi","year":"2020","journal-title":"Food Chem. Toxicol."},{"key":"ref_140","doi-asserted-by":"crossref","unstructured":"Dabuo, B., Avogo, E.W., Koomson, G.O., Akantibila, M., and Gbati, D.A. (2022). Aflatoxins: Toxicity, Occurrences and Chronic Exposure, in Aflatoxins-Occurrence, Detection and Novel Detoxification Strategies, IntechOpen.","DOI":"10.5772\/intechopen.105723"},{"key":"ref_141","doi-asserted-by":"crossref","unstructured":"Turner, P.C., and Snyder, J.A. (2021). Development and limitations of exposure biomarkers to dietary contaminants mycotoxins. Toxins, 13.","DOI":"10.3390\/toxins13050314"},{"key":"ref_142","unstructured":"Xue, K.S. (2025, April 29). Toxic Effects and Intervention Strategies for Co-Exposure to Aflatoxins and Fumonisins in Animals and High-Risk Human Populations. University of Georgia. Available online: https:\/\/getd.libs.uga.edu\/pdfs\/xue_kathy_s_201705_phd.pdf."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.chroma.2018.03.030","article-title":"Liquid chromatography\u2013high resolution mass spectrometry method for monitoring of 17 mycotoxins in human plasma for exposure studies","volume":"1548","author":"Slobodchikova","year":"2018","journal-title":"J. Chromatogr. A"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.fct.2016.11.002","article-title":"Aflatoxin B1-lysine adduct in dried blood spot samples of animals and humans","volume":"98","author":"Xue","year":"2016","journal-title":"Food Chem. Toxicol."},{"key":"ref_145","doi-asserted-by":"crossref","unstructured":"Adaku Chilaka, C., and Mally, A. (2020). Mycotoxin occurrence, exposure and health implications in infants and young children in Sub-Saharan Africa: A review. Foods, 9.","DOI":"10.3390\/foods9111585"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"785","DOI":"10.4315\/0362-028X.JFP-18-367","article-title":"Concentration and prevalence of aflatoxin M1 in human breast milk in Iran: Systematic review, meta-analysis, and carcinogenic risk assessment: A review","volume":"82","author":"Fakhri","year":"2019","journal-title":"J. Food Prot."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.aninu.2020.11.002","article-title":"An overview of aflatoxin B1 biotransformation and Aflatoxin M1 secretion in lactating dairy cows","volume":"7","author":"Min","year":"2021","journal-title":"Anim. Nutr."},{"key":"ref_148","doi-asserted-by":"crossref","unstructured":"Li, K., Cai, H., Luo, B., Duan, S., Yang, J., Zhang, N., He, Y., Wu, A., and Liu, H. (2025). Recent Progress of Mycotoxin in Various Food Products\u2014Human Exposure and Health Risk Assessment. Foods, 14.","DOI":"10.3390\/foods14050865"},{"key":"ref_149","doi-asserted-by":"crossref","unstructured":"Ezekiel, C.N., Abia, W.A., Braun, D., \u0160arkanj, B., Ayeni, K.I., Oyedele, O.A., Michael-Chikezie, E.C., Ezekiel, V.C., Mark, B., and Ahuchaogu, C.P. (2020). Comprehensive mycotoxin exposure biomonitoring in breastfed and non-exclusively breastfed Nigerian children. medRxiv.","DOI":"10.1101\/2020.05.28.20115055"},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"096001","DOI":"10.1289\/EHP1953","article-title":"Environmental chemicals in breast milk and formula: Exposure and risk assessment implications","volume":"126","author":"Lehmann","year":"2018","journal-title":"Environ. Health Perspect."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.fct.2018.11.047","article-title":"Aflatoxin B1: A review on metabolism, toxicity, occurrence in food, occupational exposure, and detoxification methods","volume":"124","author":"Rushing","year":"2019","journal-title":"Food Chem. Toxicol."},{"key":"ref_152","doi-asserted-by":"crossref","unstructured":"Mupunga, I., van Rensburg, I.J., Luthuli, N., Abafe, O.A., Shai, L.J., and Katerere, D.R. (2021). Analysis of aflatoxin biomarkers in the hair of experimental animals. Toxins, 13.","DOI":"10.3390\/toxins13080570"},{"key":"ref_153","doi-asserted-by":"crossref","unstructured":"Wang, L., Huang, Q., Wu, J., Wu, W., Jiang, J., Yan, H., Huang, J., Sun, Y., and Deng, Y. (2022). The metabolism and biotransformation of AFB1: Key enzymes and pathways. Biochem. Pharmacol., 199.","DOI":"10.1016\/j.bcp.2022.115005"},{"key":"ref_154","doi-asserted-by":"crossref","unstructured":"Eaton, D.L., Williams, D.E., and Coulombe, R.A. (2025). Species differences in the biotransformation of aflatoxin B1: Primary determinants of relative carcinogenic potency in different animal species. Toxins, 17.","DOI":"10.3390\/toxins17010030"},{"key":"ref_155","doi-asserted-by":"crossref","unstructured":"Kensler, T.W., and Groopman, J.D. (2019). Aflatoxin Exposure, Human Liver Cancer Risk, and Chemoprevention. Carcinogens, DNA Damage and Cancer Risk: Mechanisms of Chemical Carcinogenesis, World Scientific.","DOI":"10.1142\/9789813237209_0006"},{"key":"ref_156","unstructured":"Hamzehloo-Moghadam, M., Asri, N., Sherafat, S.J., and Mansouri, V. (2024). Detection of aflatoxin contamination through biomarker discovery in human intestinal Caco-2 cells. Appl. Food Biotechnol., 11."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1590\/S1984-82502012000300011","article-title":"Aflatoxin M1 in the urine of non-carriers and chronic carriers of hepatitis B virus in Maringa, Brazil","volume":"48","author":"Giolo","year":"2012","journal-title":"Braz. J. Pharm. Sci."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.foodcont.2009.08.004","article-title":"Occurrence of AFM1 in urine samples of a Brazilian population and association with food consumption","volume":"21","author":"Ferreira","year":"2010","journal-title":"Food Control"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.envint.2013.04.002","article-title":"Multimycotoxin analysis in urines to assess infant exposure: A case study in Cameroon","volume":"57","author":"Ediage","year":"2013","journal-title":"Environ. Int."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jchromb.2013.10.017","article-title":"A high-throughput method for the simultaneous determination of multiple mycotoxins in human and laboratory animal biological fluids and tissues by PLE and HPLC\u2013MS\/MS","volume":"942","author":"Cao","year":"2013","journal-title":"J. Chromatogr. B"},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1002\/ijc.20951","article-title":"Fecal and urinary excretion of aflatoxin B1 metabolites (AFQ1, AFM1 and AFB-N7-guanine) in young Chinese males","volume":"115","author":"Zhu","year":"2005","journal-title":"Int. J. Cancer"},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.fct.2013.10.003","article-title":"Bio-monitoring of mycotoxin exposure in Cameroon using a urinary multi-biomarker approach","volume":"62","author":"Abia","year":"2013","journal-title":"Food Chem. Toxicol."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1021\/tx060108d","article-title":"Quantification of aflatoxin-b1-n7-guanine in human urine by high-performance liquid chromatography and isotope dilution tandem mass spectrometry1","volume":"19","author":"Egner","year":"2006","journal-title":"Chem. Res. Toxicol."},{"key":"ref_164","first-page":"143","article-title":"Hepatocellular carcinoma and aflatoxin exposure in Zhuqing village, Fusui county, People\u2019s Republic of China","volume":"10","author":"Wang","year":"2001","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/BF02954817","article-title":"Monitoring of mycotoxin biomarkers in the Czech Republic","volume":"21","author":"Ostry","year":"2005","journal-title":"Mycotoxin Res."},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/156482650502600106","article-title":"Prevalence of Aflatoxins in blood and urine of Egyptian infants with protein\u2013energy malnutrition","volume":"26","author":"Hatem","year":"2005","journal-title":"Food Nutr. Bull."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.fct.2007.08.034","article-title":"Urinary biomarkers of aflatoxin exposure in young children from Egypt and Guinea","volume":"46","author":"Polychronaki","year":"2008","journal-title":"Food Chem. Toxicol."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1080\/19440049.2012.658442","article-title":"Characterisation of aflatoxin and deoxynivalenol exposure among pregnant Egyptian women","volume":"29","author":"Piekkola","year":"2012","journal-title":"Food Addit. Contam. Part A"},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1007\/s00128-012-0853-y","article-title":"Association between aflatoxin M 1 excreted in human urine samples with the consumption of milk and dairy products","volume":"89","author":"Rosita","year":"2012","journal-title":"Bull. Environ. Contam. Toxicol."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1002\/rcm.6255","article-title":"Development and validation of a rapid multi-biomarker liquid chromatography\/tandem mass spectrometry method to assess human exposure to mycotoxins","volume":"26","author":"Warth","year":"2012","journal-title":"Rapid Commun. Mass Spectrom."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.chroma.2012.10.071","article-title":"Development and application of salting-out assisted liquid\/liquid extraction for multi-mycotoxin biomarkers analysis in pig urine with high performance liquid chromatography\/tandem mass spectrometry","volume":"1292","author":"Song","year":"2013","journal-title":"J. Chromatogr. A"},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.envint.2014.02.003","article-title":"Mycotoxin exposure in rural residents in northern Nigeria: A pilot study using multi-urinary biomarkers","volume":"66","author":"Ezekiel","year":"2014","journal-title":"Environ. Int."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.jchromb.2017.10.006","article-title":"Quantitative determination of carcinogenic mycotoxins in human and animal biological matrices and animal-derived foods using multi-mycotoxin and analyte-specific high performance liquid chromatography-tandem mass spectrometric methods","volume":"1073","author":"Cao","year":"2018","journal-title":"J. Chromatogr. B"},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.fct.2017.11.030","article-title":"Aflatoxin exposure in Nigerian children with severe acute malnutrition","volume":"111","author":"McMillan","year":"2018","journal-title":"Food Chem. Toxicol."},{"key":"ref_175","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1053\/j.gastro.2017.04.005","article-title":"Association of aflatoxin and gallbladder cancer","volume":"153","author":"Koshiol","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_176","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1080\/19393210.2016.1216468","article-title":"Aspergillus and aflatoxin in groundnut (Arachis hypogaea L.) and groundnut cake in Eastern Ethiopia","volume":"9","author":"Mohammed","year":"2016","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"e12701","DOI":"10.1111\/mcn.12701","article-title":"Maternal aflatoxin exposure during pregnancy and adverse birth outcomes in Uganda","volume":"15","author":"Lauer","year":"2019","journal-title":"Matern. Child Nutr."},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"e12619","DOI":"10.1111\/mcn.12619","article-title":"Low level aflatoxin exposure associated with greater linear growth in southern Mexico: A longitudinal study","volume":"14","author":"Leroy","year":"2018","journal-title":"Matern. Child Nutr."},{"key":"ref_179","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.socscimed.2015.10.039","article-title":"Serum aflatoxin B1-lysine adduct level in adult women from Eastern Province in Kenya depends on household socio-economic status: A cross sectional study","volume":"146","author":"Leroy","year":"2015","journal-title":"Soc. Sci. Med."},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"1601049","DOI":"10.1002\/mnfr.201601049","article-title":"Determinants of recent aflatoxin exposure among pregnant women in rural Zimbabwe","volume":"61","author":"Smith","year":"2017","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_181","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.envint.2018.03.001","article-title":"Exposure to aflatoxin and fumonisin in children at risk for growth impairment in rural Tanzania","volume":"115","author":"Chen","year":"2018","journal-title":"Environ. Int."},{"key":"ref_182","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1038\/s41370-018-0066-5","article-title":"Aflatoxin exposure in children living in Mirpur, Dhaka: Data from MAL-ED companion study","volume":"29","author":"Mahfuz","year":"2019","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_183","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1093\/ije\/dyv027","article-title":"Exposure to aflatoxin B1 in utero is associated with DNA methylation in white blood cells of infants in The Gambia","volume":"44","author":"Castelino","year":"2015","journal-title":"Int. J. Epidemiol."},{"key":"ref_184","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s12550-018-0314-5","article-title":"Aflatoxin-lysine adducts in blood serum of the Malawian rural population and aflatoxin contamination in foods (groundnuts, maize) in the corresponding areas","volume":"34","author":"Seetha","year":"2018","journal-title":"Mycotoxin Res."},{"key":"ref_185","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1002\/mnfr.201500382","article-title":"Dietary exposure to aflatoxin and micronutrient status among young children from Guinea","volume":"60","author":"Watson","year":"2016","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_186","doi-asserted-by":"crossref","unstructured":"Watson, S., Moore, S.E., Darboe, M.K., Chen, G., Tu, Y.-K., Huang, Y.-T., Eriksen, K.G., Bernstein, R.M., Prentice, A.M., and Wild, C.P. (2018). Impaired growth in rural Gambian infants exposed to aflatoxin: A prospective cohort study. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-6164-4"},{"key":"ref_187","doi-asserted-by":"crossref","first-page":"10556","DOI":"10.1021\/acs.analchem.7b02777","article-title":"Design of multifunctional nanostructure for ultrafast extraction and purification of Aflatoxins in foodstuffs","volume":"89","author":"Xie","year":"2017","journal-title":"Anal. Chem."},{"key":"ref_188","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1080\/19440049.2015.1048749","article-title":"Longitudinal evaluation of aflatoxin exposure in two cohorts in south-western Uganda","volume":"32","author":"Kang","year":"2015","journal-title":"Food Addit. Contam. Part A"},{"key":"ref_189","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1289\/ehp.1408097","article-title":"A prospective study of growth and biomarkers of exposure to aflatoxin and fumonisin during early childhood in Tanzania","volume":"123","author":"Shirima","year":"2015","journal-title":"Environ. Health Perspect."},{"key":"ref_190","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1080\/02652030701713939","article-title":"Pilot survey of aflatoxin\u2013albumin adducts in sera from Egypt","volume":"25","author":"Turner","year":"2008","journal-title":"Food Addit. Contam."},{"key":"ref_191","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1365-3156.2009.02435.x","article-title":"Association between birth outcomes and aflatoxin B1 biomarker blood levels in pregnant women in Kumasi, Ghana","volume":"15","author":"Shuaib","year":"2010","journal-title":"Trop. Med. Int. Health"},{"key":"ref_192","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1016\/S0140-6736(05)66661-5","article-title":"Reduction in exposure to carcinogenic Aflatoxins by postharvest intervention measures in West Africa: A community-based intervention study","volume":"365","author":"Turner","year":"2005","journal-title":"Lancet"},{"key":"ref_193","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1080\/19440049.2013.789558","article-title":"Human aflatoxin exposure in Kenya, 2007: A cross-sectional study","volume":"30","author":"Yard","year":"2013","journal-title":"Food Addit. Contam. Part A"},{"key":"ref_194","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.ijheh.2011.12.005","article-title":"Associations of serum aflatoxin B1\u2013lysine adduct level with socio-demographic factors and Aflatoxins intake from nuts and related nut products in Malaysia","volume":"215","author":"Leong","year":"2012","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_195","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/13590840601016478","article-title":"Aflatoxins and ochratoxins in serum samples of school children","volume":"16","year":"2007","journal-title":"J. Nutr. Environ. Med."},{"key":"ref_196","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1093\/ije\/dym122","article-title":"Aflatoxin exposure in utero causes growth faltering in Gambian infants","volume":"36","author":"Turner","year":"2007","journal-title":"Int. J. Epidemiol."},{"key":"ref_197","doi-asserted-by":"crossref","first-page":"6027","DOI":"10.1016\/j.scitotenv.2010.09.005","article-title":"Aflatoxin and PAH exposure biomarkers in a US population with a high incidence of hepatocellular carcinoma","volume":"408","author":"Johnson","year":"2010","journal-title":"Sci. Total Environ."},{"key":"ref_198","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1080\/02652030600627222","article-title":"Determinants of aflatoxin M1 in breast milk in a selected group of Egyptian mothers","volume":"23","author":"Polychronaki","year":"2006","journal-title":"Food Addit. Contam."},{"key":"ref_199","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.fct.2009.10.016","article-title":"Exposure of newborns to aflatoxin M1 and B1 from mothers\u2019 breast milk in Ankara, Turkey","volume":"48","author":"Girgin","year":"2010","journal-title":"Food Chem. Toxicol."},{"key":"ref_200","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1179\/027249303322296484","article-title":"Aflatoxin M1 in breast-milk of UAE women","volume":"23","author":"Abdulrazzaq","year":"2003","journal-title":"Ann. Trop. Pediatr."},{"key":"ref_201","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1039\/D1JA90007B","article-title":"Atomic spectrometry update: Review of advances in the analysis of clinical and biological materials, foods and beverages","volume":"36","author":"Patriarca","year":"2021","journal-title":"J. Anal. At. Spectrom."},{"key":"ref_202","doi-asserted-by":"crossref","first-page":"5897","DOI":"10.1007\/s00216-019-01971-3","article-title":"Development and validation of a multianalyte immunoassay for the quantification of environmental pollutants in seawater samples from the Catalonia coastal area","volume":"411","author":"Sanchis","year":"2019","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_203","unstructured":"Devalloir, Q. (2023). Effects of Multi-Stressors (Pollution, Nutritional Quality) on the Immunocompetence of the Wood Mouse. [Ph.D. Thesis, Universit\u00e9 Bourgogne Franche-Comt\u00e9]. Available online: https:\/\/theses.hal.science\/tel-04598579."},{"key":"ref_204","doi-asserted-by":"crossref","unstructured":"Afzal, A., and Mahreen, N. (2024). Emerging insights into the impacts of heavy metals exposure on health, reproductive and productive performance of livestock. Front. Pharmacol., 15.","DOI":"10.3389\/fphar.2024.1375137"},{"key":"ref_205","doi-asserted-by":"crossref","unstructured":"Kraft, S., Buchenauer, L., and Polte, T. (2021). Mold, mycotoxins and a dysregulated immune system: A combination of concern?. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222212269"},{"key":"ref_206","doi-asserted-by":"crossref","unstructured":"Gao, Y., Meng, L., Liu, H., Wang, J., and Zheng, N. (2020). The compromised intestinal barrier induced by mycotoxins. Toxins, 12.","DOI":"10.3390\/toxins12100619"},{"key":"ref_207","doi-asserted-by":"crossref","unstructured":"Gonkowski, S., Gaj\u0119cka, M., and Makowska, K. (2020). Mycotoxins and the enteric nervous system. Toxins, 12.","DOI":"10.3390\/toxins12070461"},{"key":"ref_208","doi-asserted-by":"crossref","unstructured":"Huang, Q., Jiang, K., Tang, Z., Fan, K., Meng, J., Nie, D., Zhao, Z., Wu, Y., and Han, Z. (2021). Exposure assessment of multiple mycotoxins and cumulative health risk assessment: A biomonitoring-based study in the Yangtze River Delta, China. Toxins, 13.","DOI":"10.3390\/toxins13020103"},{"key":"ref_209","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1007\/s00204-022-03288-0","article-title":"Assessment of multiple mycotoxin exposure and its association with food consumption: A human biomonitoring study in a pregnant cohort in rural Bangladesh","volume":"96","author":"Kyei","year":"2022","journal-title":"Arch. Toxicol."},{"key":"ref_210","doi-asserted-by":"crossref","first-page":"14","DOI":"10.14252\/foodsafetyfscj.2015026","article-title":"Aflatoxin exposure and associated human health effects, a review of epidemiological studies","volume":"4","author":"Gong","year":"2016","journal-title":"Food Saf."},{"key":"ref_211","doi-asserted-by":"crossref","unstructured":"Sumon, A.H., Islam, F., Mohanto, N.C., Kathak, R.R., Molla, N.H., Rana, S., Degen, G.H., and Ali, N. (2021). The presence of Aflatoxin M1 in milk and milk products in Bangladesh. Toxins, 13.","DOI":"10.3390\/toxins13070440"},{"key":"ref_212","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2741\/e77","article-title":"Simultaneous determination of mycotoxins in biological fluids by LC-MS\/MS","volume":"2","author":"Ritieni","year":"2010","journal-title":"Front. Biosci."},{"key":"ref_213","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1080\/15287394.2012.721174","article-title":"Incidence of aflatoxin M1 in human and animal milk in Jordan","volume":"75","author":"Omar","year":"2012","journal-title":"J. Toxicol. Environ. Health Part A"},{"key":"ref_214","doi-asserted-by":"crossref","unstructured":"Ko\u015bcielecka, K., Ku\u0107, A., Kubik-Machura, D., M\u0119cik-Kronenberg, T., W\u0142odarek, J., and Radko, L. (2023). Endocrine effect of some mycotoxins on humans: A clinical review of the ways to mitigate the action of mycotoxins. Toxins, 15.","DOI":"10.3390\/toxins15090515"},{"key":"ref_215","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1136\/bmj.325.7354.20","article-title":"Dietary aflatoxin exposure and impaired growth in young children from Benin and Togo: Cross-sectional study","volume":"325","author":"Gong","year":"2002","journal-title":"Br. Med. J."},{"key":"ref_216","doi-asserted-by":"crossref","unstructured":"Kensler, T.W., and Eaton, D.L. (2024). 65 Years on\u2014Aflatoxin Biomarkers Blossoming: Whither Next?. Toxins, 16.","DOI":"10.3390\/toxins16110496"},{"key":"ref_217","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.fct.2019.04.047","article-title":"Aflatoxin, fumonisin, ochratoxin, zearalenone and deoxynivalenol biomarkers in human biological fluids: A systematic literature review, 2001\u20132018","volume":"129","author":"Jaganjac","year":"2019","journal-title":"Food Chem. Toxicol."},{"key":"ref_218","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4314\/ahs.v23i2.9","article-title":"Aflatoxin exposure in a population of HIV patients at risk of hepatocellular carcinoma, North-Central, Nigeria","volume":"23","author":"Davwar","year":"2023","journal-title":"Afr. Health Sci."},{"key":"ref_219","doi-asserted-by":"crossref","unstructured":"Jolly, P.E., Akinyemiju, T.F., Sakhuja, S., and Sheth, R. (2022). Association of aflatoxin B1 levels with mean CD4 cell count and uptake of ART among HIV infected patients: A prospective study. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0260873"},{"key":"ref_220","doi-asserted-by":"crossref","unstructured":"Madeen, E.P., Maldarelli, F., and Groopman, J.D. (2021). Environmental pollutants, mucosal barriers, and pathogen susceptibility; the case for aflatoxin b1 as a risk factor for hiv transmission and pathogenesis. Pathogens, 10.","DOI":"10.3390\/pathogens10101229"},{"key":"ref_221","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/s41572-023-00452-3","article-title":"HIV infection","volume":"9","author":"Bekker","year":"2023","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_222","unstructured":"Mutua, F.K., Grace, D., and Watts, C. (2021). Food Safety Investments in East Africa, International Livestock Research Institute."},{"key":"ref_223","doi-asserted-by":"crossref","unstructured":"Rasouli, H., Nayeri, F.D., and Khodarahmi, R. (2022). May phytophenolics alleviate Aflatoxins-induced health challenges? A holistic insight on current landscape and future prospects. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.981984"},{"key":"ref_224","unstructured":"Dabuo, B., Xorlali, N., Amoliga, N.T., Atibodu, Z.K., Newman, P.M., Mohammed, A., Ali, R.A., and Abudu, A. (2025, April 29). Aspergillus and Aspergillosis in People with Chronic Diseases. Available online: https:\/\/www.intechopen.com\/chapters\/87304."},{"key":"ref_225","doi-asserted-by":"crossref","unstructured":"Gurunathan, S., Lee, A.R., and Kim, J.H. (2022). Antifungal effect of nanoparticles against COVID-19 linked black fungus: A perspective on biomedical applications. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232012526"},{"key":"ref_226","doi-asserted-by":"crossref","unstructured":"Malvandi, A.M., Shahba, S., Mehrzad, J., and Lombardi, G. (2022). Metabolic disruption by naturally occurring mycotoxins in circulation: A focus on vascular and bone homeostasis dysfunction. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.915681"},{"key":"ref_227","doi-asserted-by":"crossref","unstructured":"Ye, D., Hao, Z., Tang, S., Velkov, T., and Dai, C. (2024). Aflatoxin exposure-caused male reproductive toxicity: Molecular mechanisms, detoxification, and future directions. Biomolecules, 14.","DOI":"10.3390\/biom14111460"},{"key":"ref_228","doi-asserted-by":"crossref","unstructured":"Kannan, K., George, J.A., Sahadevan, R., Kothari, M., and Sadhukhan, S. (2024). Insights into one drug, multi-target aspects of polyphenols for diabetes management: In vitro, in vivo, and clinical evidence. Phytochem. Rev., 1\u201349.","DOI":"10.1007\/s11101-024-10047-9"},{"key":"ref_229","doi-asserted-by":"crossref","first-page":"792","DOI":"10.2174\/1568009623666230418121130","article-title":"The role of oxidative stress in the development and therapeutic intervention of hepatocellular carcinoma","volume":"23","author":"Liu","year":"2023","journal-title":"Curr. Cancer Drug Targets"},{"key":"ref_230","doi-asserted-by":"crossref","first-page":"120483","DOI":"10.1016\/j.lfs.2022.120483","article-title":"A system biology approach to determine therapeutic targets by identifying molecular mechanisms and key pathways for type 2 diabetes that are linked to the development of tuberculosis and rheumatoid arthritis","volume":"297","author":"Hasan","year":"2022","journal-title":"Life Sci."},{"key":"ref_231","doi-asserted-by":"crossref","first-page":"2455","DOI":"10.3390\/microbiolres15040165","article-title":"Sex-and Gender-Specific Considerations in Mycotoxin Screening: Assessing Differential Exposure, Health Impacts, and Mitigation Strategies","volume":"15","author":"Thenuwara","year":"2024","journal-title":"Microbiol. Res."},{"key":"ref_232","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/hep.31288","article-title":"Epidemiology of hepatocellular carcinoma","volume":"73","author":"McGlynn","year":"2021","journal-title":"Hepatology"},{"key":"ref_233","first-page":"3121","article-title":"Cancer causes and treatments","volume":"11","author":"Saini","year":"2020","journal-title":"Int. J. Pharm. Sci. Res."},{"key":"ref_234","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s11160-007-9064-8","article-title":"Aflatoxins in aquatic species: Metabolism, toxicity and perspectives","volume":"18","author":"Santacroce","year":"2008","journal-title":"Rev. Fish Biol. Fish."},{"key":"ref_235","doi-asserted-by":"crossref","unstructured":"Marchese, S., Polo, A., Ariano, A., Velotto, S., Costantini, S., and Severino, L. (2018). Aflatoxin B1 and M1: Biological properties and their involvement in cancer development. Toxins, 10.","DOI":"10.3390\/toxins10060214"},{"key":"ref_236","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.tox.2012.08.012","article-title":"Reactive oxygen species sources and biomolecular oxidative damage induced by aflatoxin B1 and fumonisin B1 in rat spleen mononuclear cells","volume":"302","author":"Mary","year":"2012","journal-title":"Toxicology"},{"key":"ref_237","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12964-023-01398-5","article-title":"Interplay of oxidative stress, cellular communication and signaling pathways in cancer","volume":"22","author":"Iqbal","year":"2024","journal-title":"Cell Commun. Signal."},{"key":"ref_238","doi-asserted-by":"crossref","unstructured":"Dai, C., Tian, E., Hao, Z., Tang, S., Wang, Z., Sharma, G., Jiang, H., and Shen, J. (2022). Aflatoxin B1 toxicity and protective effects of curcumin: Molecular mechanisms and clinical implications. Antioxidants, 11.","DOI":"10.3390\/antiox11102031"},{"key":"ref_239","doi-asserted-by":"crossref","unstructured":"R\u00e1duly, Z., Szab\u00f3, L., Madar, A., P\u00f3csi, I., and Csernoch, L. (2020). Toxicological and medical aspects of Aspergillus-derived mycotoxins entering the feed and food chain. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.02908"},{"key":"ref_240","doi-asserted-by":"crossref","unstructured":"Popescu, R.G., R\u0103dulescu, A.L., Georgescu, S.E., and Dinischiotu, A. (2022). Aflatoxins in feed: Types, metabolism, health consequences in swine and mitigation strategies. Toxins, 14.","DOI":"10.3390\/toxins14120853"},{"key":"ref_241","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1159\/000485089","article-title":"Antioxidants maintain cellular redox homeostasis by elimination of reactive oxygen species","volume":"44","author":"He","year":"2017","journal-title":"Cell. Physiol. Biochem."},{"key":"ref_242","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2174\/1566524022666211222161637","article-title":"Free radicals and oxidative stress: Signaling mechanisms, redox basis for human diseases, and cell cycle regulation","volume":"23","author":"Sadiq","year":"2023","journal-title":"Curr. Mol. Med."},{"key":"ref_243","doi-asserted-by":"crossref","unstructured":"Malik, S., Krishnaswamy, K., and Mustapha, A. (2021). Hazard analysis and risk-based preventive controls (HARPC): Current food safety and quality standards for complementary foods. Foods, 10.","DOI":"10.3390\/foods10092199"},{"key":"ref_244","unstructured":"Mishra, R., Madhav, S., Dhaka, R.K., and Garg, P. (2024). Biomarkers in Environmental and Human Health Biomonitoring: An Integrated Perspective, Elsevier."},{"key":"ref_245","doi-asserted-by":"crossref","unstructured":"Dropulic, L.K., and Lederman, H.M. (2016). Overview of infections in the immunocompromised host. Diagn. Microbiol. Immunocompromised Host, 4.","DOI":"10.1128\/microbiolspec.DMIH2-0026-2016"},{"key":"ref_246","doi-asserted-by":"crossref","unstructured":"Omar, S.S., Haddad, M.A., and Parisi, S. (2020). Validation of HPLC and Enzyme-Linked Immunosorbent Assay (ELISA) techniques for detection and quantification of Aflatoxins in different food samples. Foods, 9.","DOI":"10.3390\/foods9050661"},{"key":"ref_247","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1016\/j.cgh.2019.12.026","article-title":"Nonalcoholic fatty liver disease and fibrosis associated with increased risk of cardiovascular events in a prospective study","volume":"18","author":"Baratta","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_248","doi-asserted-by":"crossref","unstructured":"Wenndt, A., Mutua, F., Grace, D., Thomas, L.F., and Lambertini, E. (2023). Quantitative assessment of aflatoxin exposure and hepatocellular carcinoma (HCC) risk associated with consumption of select Nigerian staple foods. Front. Sustain. Food Syst., 7.","DOI":"10.3389\/fsufs.2023.1128540"},{"key":"ref_249","first-page":"CD013376","article-title":"Agricultural and nutritional education interventions for reducing aflatoxin exposure to improve infant and child growth in low-and middle-income countries","volume":"2020","author":"Visser","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_250","unstructured":"Wild, C.P., Miller, J.D., and Groopman, J.D. (2015). Intervention Strategies to Reduce Human Exposure to Aflatoxins and Fumonisins. Mycotoxin Control in Low-and Middle-Income Countries, International Agency for Research on Cancer (IARC)."},{"key":"ref_251","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1172\/JCI134165","article-title":"Insulin resistance drives hepatic de novo lipogenesis in nonalcoholic fatty liver disease","volume":"130","author":"Smith","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_252","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1097\/QAI.0000000000002656","article-title":"COVID-19 burden and risk among people with HIV\/AIDS","volume":"87","author":"Jones","year":"2021","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_253","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.ccell.2022.02.012","article-title":"Impact of COVID-19 on case fatality rate of patients with cancer during the Omicron wave","volume":"40","author":"Lee","year":"2022","journal-title":"Cancer Cell"},{"key":"ref_254","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1289\/ehp.0901388","article-title":"Global burden of aflatoxin-induced hepatocellular carcinoma: A risk assessment","volume":"118","author":"Liu","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_255","unstructured":"Mupunga, I. (2025, April 29). A Comparative Study of Natural Contamination with Aflatoxins and Fumonisins in Selected Food Commodities from Botswana and Zimbabwe. University of South Africa. Available online: https:\/\/www.researchgate.net\/publication\/313888038_A_comparative_study_of_natural_contamination_with_aflatoxins_and_fumonisins_in_selected_food_commodities_from_Botswana_and_Zimbabwe."}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/8\/414\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:29:09Z","timestamp":1760034549000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/8\/414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,16]]},"references-count":255,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["toxins17080414"],"URL":"https:\/\/doi.org\/10.3390\/toxins17080414","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,16]]}}}