Wang, Jia-Sheng

Early Life Exposure to Mycotoxins and Child Linear Growth in Nepal: Methods and Design of a Prospective Birth Cohort Study

Publication Type


A growing body of mainly cross-sectional evidence suggests an association between mycotoxins, particularly aflatoxin exposure, and poor linear growth in children. We describe the design and methods of a rigorous longitudinal birth cohort study aimed to deepen our understanding of this hypothesized relationship and to validate dried blood spots as a less invasive, low-cost collection method for venous blood samples. The AflaCohort study was conducted in Banke district of Nepal from 2015 to 2019.

Relatively Low Maternal Aflatoxin Exposure Is Associated with Small-for-Gestational-Age but Not with Other Birth Outcomes in a Prospective Birth Cohort Study of Nepalese Infants

Publication Type

This study used maternal and newborn data from the AflaCohort Study, an ongoing birth cohort study in Banke, Nepal (= 1621). Data on aflatoxin B1(AFB1)-lysine adducts in maternal serum were collected once during pregnancy (at mean ± SD: 136 ± 43 d of gestation). Maternal serum AFB1-lysine adduct concentration was measured via HPLC.

Association between maternal aflatoxin exposure during pregnancy and adverse birth outcomes in Uganda

Publication Type

Aflatoxins are toxic metabolites of Aspergillus molds and are widespread in the food supply, particularly in low‐ and middle‐income countries (LMICs). Both in utero and infant exposure to aflatoxin B1 (AFB1) have been linked to poor child growth and development. The objective of this prospective cohort study was to investigate the association between maternal aflatoxin exposure during pregnancy and adverse birth outcomes, primarily lower birth weight, in a sample of 220 mother‐infant pairs in Mukono district, Uganda.

HIV-Infected Pregnant and Lactating Women have Higher Serum Aflatoxin levels than HIV-Uninfected Women and Aflatoxin Levels are Higher during Early Postpartum than during Pregnancy among HIV-Infected Women

Publication Type

Aflatoxins are carcinogenic and may affect linear growth. Prior cross-sectional data from Ghana have shown that aflatoxin levels are ~ 20% higher among HIV-infected than HIV-uninfected post-partum women. It is not known if HIV-infected pregnant women have elevated serum aflatoxin levels during pregnancy, or if aflatoxin levels change during the perinatal period. We therefore studied these relationships among a cohort of 246 women recruited in Gulu, Uganda, and followed through pregnancy and early infant life.