Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening
This case-control study adds to the growing body of knowledge on the medical, nutritional, and environmental factors associated with Nodding Syndrome (NS), a seizure disorder of children and adolescents in northern Uganda. Past research described a significant association between NS and prior histor...
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| Format: | Article |
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MDPI AG
2021-04-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/13/5/313 |
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| author | Jennifer Duringer Rajarshi Mazumder Valerie Palmer A. Morrie Craig Peter Spencer |
| author_facet | Jennifer Duringer Rajarshi Mazumder Valerie Palmer A. Morrie Craig Peter Spencer |
| author_sort | Jennifer Duringer |
| collection | DOAJ |
| description | This case-control study adds to the growing body of knowledge on the medical, nutritional, and environmental factors associated with Nodding Syndrome (NS), a seizure disorder of children and adolescents in northern Uganda. Past research described a significant association between NS and prior history of measles infection, dependence on emergency food and, at head nodding onset, subsistence on moldy maize, which has the potential to harbor mycotoxins. We used LC-MS/MS to screen for current mycotoxin loads by evaluating nine analytes in urine samples from age-and-gender matched NS cases (n = 50) and Community Controls (CC, n = 50). The presence of the three mycotoxins identified in the screening was not significantly different between the two groups, so samples were combined to generate an overall view of exposure in this community during the study. Compared against subsequently run standards, α-zearalenol (43 ± 103 µg/L in 15 samples > limit of quantitation (LOQ); 0 (0/359) µg/L), T-2 toxin (39 ± 81 µg/L in 72 samples > LOQ; 0 (0/425) µg/L) and aflatoxin M1 (4 ± 10 µg/L in 15 samples > LOQ; 0 (0/45) µg/L) were detected and calculated as the average concentration ± SD; median (min/max). Ninety-five percent of the samples had at least one urinary mycotoxin; 87% were positive for two of the three compounds detected. While mycotoxin loads at NS onset years ago are and will remain unknown, this study showed that children with and without NS currently harbor foodborne mycotoxins, including those associated with maize. |
| first_indexed | 2024-03-10T11:54:48Z |
| format | Article |
| id | doaj.art-2d848be4eff7479188a6cdc4ffc4b5bc |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T11:54:48Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-2d848be4eff7479188a6cdc4ffc4b5bc2023-11-21T17:21:43ZengMDPI AGToxins2072-66512021-04-0113531310.3390/toxins13050313Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin ScreeningJennifer Duringer0Rajarshi Mazumder1Valerie Palmer2A. Morrie Craig3Peter Spencer4Department of Environmental & Molecular Toxicology, Oregon State University, Corvallis, OR 97331, USADepartment of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USADepartment of Neurology, Oregon Health & Science University, Portland, OR 97239, USADepartment of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USADepartment of Neurology, Oregon Health & Science University, Portland, OR 97239, USAThis case-control study adds to the growing body of knowledge on the medical, nutritional, and environmental factors associated with Nodding Syndrome (NS), a seizure disorder of children and adolescents in northern Uganda. Past research described a significant association between NS and prior history of measles infection, dependence on emergency food and, at head nodding onset, subsistence on moldy maize, which has the potential to harbor mycotoxins. We used LC-MS/MS to screen for current mycotoxin loads by evaluating nine analytes in urine samples from age-and-gender matched NS cases (n = 50) and Community Controls (CC, n = 50). The presence of the three mycotoxins identified in the screening was not significantly different between the two groups, so samples were combined to generate an overall view of exposure in this community during the study. Compared against subsequently run standards, α-zearalenol (43 ± 103 µg/L in 15 samples > limit of quantitation (LOQ); 0 (0/359) µg/L), T-2 toxin (39 ± 81 µg/L in 72 samples > LOQ; 0 (0/425) µg/L) and aflatoxin M1 (4 ± 10 µg/L in 15 samples > LOQ; 0 (0/45) µg/L) were detected and calculated as the average concentration ± SD; median (min/max). Ninety-five percent of the samples had at least one urinary mycotoxin; 87% were positive for two of the three compounds detected. While mycotoxin loads at NS onset years ago are and will remain unknown, this study showed that children with and without NS currently harbor foodborne mycotoxins, including those associated with maize.https://www.mdpi.com/2072-6651/13/5/313Nodding SyndromemycotoxinsurineUganda |
| spellingShingle | Jennifer Duringer Rajarshi Mazumder Valerie Palmer A. Morrie Craig Peter Spencer Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening Toxins Nodding Syndrome mycotoxins urine Uganda |
| title | Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening |
| title_full | Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening |
| title_fullStr | Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening |
| title_full_unstemmed | Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening |
| title_short | Case-Control Study of Nodding Syndrome in Acholiland: Urinary Multi-Mycotoxin Screening |
| title_sort | case control study of nodding syndrome in acholiland urinary multi mycotoxin screening |
| topic | Nodding Syndrome mycotoxins urine Uganda |
| url | https://www.mdpi.com/2072-6651/13/5/313 |
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