Letter to the Editor


James Karuku Kibugu
James Karuku Kibugu

I am James Karuku Kibugu, a senior Research Scientist with the Kenya Agricultural and Livestock Research Organization (KALRO). Currently I am pursuing a doctorate degree in Medical Biochemistry (Biochemical Toxicology) at Kenyatta University. My area of specialization is food and feed safety with special emphasis on dietary mycotoxins. My PhD work seeks to answer five major research questions; (1) What are the best methods for selection and preparation of samples used to estimate dietary aflatoxin residues?; (2) What are the food-borne mycotoxin hazards and the associated risk of human malignancies?; (3) What are the levels and how widespread are aflatoxin residues in chicken feed?; (4) What is the impact of long-term aflatoxin exposure on broiler chicken productivity and health?; and (5) What are the best options for managing dietary aflatoxin contamination in broiler chicken production systems? I have co-authored 20 research articles in peer reviewed scientific journals.

Email: jkkibugu1@yahoo.com

Exposure to chronic dietary aflatoxin poisoning is potentially a compromising condition in COVID-19 patients in Africa

Dear Editor,

In this time of COVID-19 pandemic, we draw attention to a potential aggravating risk factor in Kenya, one that is amenable to mitigation. Advanced age, male sex and underlying medical conditions [1,2] are the main risk factors to fatality among COVID-19 patients. Kenya has reported fatalities in relatively young people with no diagnosed underlying medical conditions. While no evidence exists on the association between aflatoxicosis and COVID 19, effects of potential risk factors such as aflatoxicosis on pathogenesis and epidemiology of COVID-19 needs to be elucidated. Our manuscript titled "Mycotoxin hazards in the Kenyan food and feed market-a retrospective study" submitted in AJFAND, suggest widespread exposure to chronic aflatoxicosis in Kenya. This corroborates observations made at the regional regulatory platform and could have serious implications on COVID-19 pandemic in Kenya and entire Africa where aflatoxicosis is common and largely uncontrolled. Attempting to elucidate this observation, we reviewed literature and associated the fatality scenario in Kenya to chronic dietary aflatoxicosis. While this communication may sound rather speculative, its purpose is to stimulate research. Aflatoxins are potent immunosuppressive agents known to aggravate pathogenesis of diseases. Of special interest is exacerbation of mucosa-associated diseases in the gastrointestinal and respiratory tracts by aflatoxins such as SARS-CoV-2 which enters through nasal and larynx mucosa [1]. Underlying medical conditions [1] and malnutrition are risk factors for COVID-19 fatality. Indeed, patients with immune dysfunction cannot mount an effective immune response against the SARS-CoV-2 to handle viremia and pneumonia phases of COVID-19 and degenerate to severe acute respiratory syndrome characterized by autoimmunity and coagulopathy. Aflatoxicosis induces immunosuppression, coagulopathy, nutritional deficiency [3], aggravates pathogenesis of experimental diseases including pulmonary viruses [4] and has a strong synergy with human viruses [3,5]. Chronic aflatoxicosis is therefore a potential underlying condition likely to increase incidence, severity and undesired outcomes of diseases such as acute respiratory disease syndrome, a deadly immunopathological event and coagulopathy in some late-stage COVID-19 patients. Further, a positive correlation has been observed between transmission of viruses and consumption of mycotoxin-prone food in Africa. Chronic mycotoxicoses are silent diseases, difficult to diagnose and escape notice of medical personnel. The male sex, a risk factor to both COVID-19 fatality [1,2] and aflatoxicosis, should be given special attention during management of the pandemic. Again, we are aware the link between aflatoxicosis and COVID-19 is speculative, that other causes of immune-suppression are common, and the actual mortality in different patient groups is difficult to evaluate precisely in Kenya. Nonetheless, effects of aflatoxicosis on pathogenesis and epidemiology of COVID-19 needs to be elucidated. We thank our funders: CGIAR Research Program, Agriculture for Nutrition and Health and KALRO.

James Kibugu1,2*, Leonard Munga2, David Mburu2, Delia Grace3, Johanna Lindahl3,4,5
1Kenya Agricultural and Livestock Research Organization, Nairobi, Kenya;
2Kenyatta University, Nairobi, Kenya;
3International Livestock Research Institute, Nairobi, Kenya;
4Swedish University of Agricultural Sciences, Uppsala, Sweden;
5Uppsala University, Uppsala, Sweden;
*Correspondence: jkkibugu1@yahoo.com


  1. Gennaro FD, Pizzol D, Marotta C, Antunes M, Racalbuto V, Veronese N and L Smith Coronavirus diseases (COVID-19) current status and future perspectives: A narrative review. Int. J. Environ. Res. Public Health 2020; 17: 2690.

  2. Jin JN, Bai P, He W, Wu F, Liu X-F, Han D-M, Liu S and J-K Yang Gender differences in patients with COVID-19: Focus on severity and mortality. Front Public Health. 2020; 8: Article 152. Available online at https://www.frontiersin.org/articles/10.3389/fpubh.2020.00152/full Accessed 13th January, 2021.

  3. Benkerroum N Chronic and acute toxicities of aflatoxins: mechanisms of action. Int. J. Environ. Res. Public Health 2020; 17: 423. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013914/ Accessed 13th January, 2021.

  4. Sun Y, Su J, Liu Z, Liu D, Gan F, Chen X and K Huang Aflatoxin B1 promotes influenza replication and increases virus related lung damage via activation of TLR4 signaling. Front Immunol. 2018; 9: Article 2297. Available online at https://www.frontiersin.org/articles/10.3389/fimmu.2018.02297/full Accessed 13th January, 2021.

  5. Zhang J, Orang’o O, Tonui P, Tong Y, Maina T, Kiptoo S, Muthoka K, Groopman J, Smith J, Madeen E, Ermel A, Loehrer P and DR Brown Detection and concentration of plasma aflatoxin is associated with detection of oncogenic human papillomavirus in Kenyan women. Open Forum Infect. Dis. 2019; 7 pages.