الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Aflatoxins, which are harmful substances found in agricultural products, are more common in hot and humid regions. The contamination of these toxins in crops used to make fermented beverages is increasing, causing concerns for human health. In order to gain a better understanding of the dietary exposure to aflatoxin and ethanol through the consumption of homemade and industrial fermented beverages in South Kivu, samples of both homemade and industrial fermented beverages were collected for analysis. Additionally, data on fermented beverage consumption was collected from 847 adults using a food frequency questionnaire. The assessment of aflatoxin exposure involved examining the correlation between the results of aflatoxin analysis and the data on individual consumption of fermented beverages. The margin of exposure (MOE) values was determined by calculating the average and 95th percentile values of aflatoxin and ethanol exposure, which are known to cause a 10% increase in hepatocellular carcinoma (HCC) formation. These values were calculated using a benchmark dose (BMDL10) recommended by the European food safety authority (EFSA). Aflatoxin B1 has a BMDL10 value of 400 ng/kg bw/day for the incidence of hepatocellular carcinoma in male rats, while ethanol has a BMDL10 value of 700 mg/kg bw/day for the incidence of hepatocellular adenoma or carcinoma based on rat data.
Furthermore, the research examined the nutritional composition of both homemade and industrial fermented beverages, as well as the effect of certain probiotic strains (specifically L. bulgaricus and S. thermophilus) and a combination thereof, on the mitigation of AFB1 concentrations within Kasiksi - a traditional fermented beverage typically brewed within the households of South Kivu residents. The acceptability of different probiotic strains was compared to each other and to a non-probiotic version of Kasiksi prepared traditionally.
The analysis involved the use of various techniques such as Kjeldahl digestion for determining crude protein content, ICP-EOS for mineral analysis, and reverse HPLC with fluorescence and refractive index detectors for measuring aflatoxins and ethanol, respectively.
The analytical method used to detect aflatoxin exhibited a satisfactory level of linearity, as indicated by determination coefficients ranging from 0.9926 to 0.9997. The method also had satisfactory recoveries ranging from 68.3% to 77.2%, with limits of detection and quantification ranging from 0.4 to 2.5 µg/L and 1.4 to 7.6 µg/L, respectively.
from this study we concluded that:
- The results show that a significant percentage of the participants (66.9%) did not know that aflatoxins come from fungi, were not aware of how moulds produce harmful substances (67.18%), and were unaware of the negative effect of aflatoxin on human health (83.59%). However, they did have some knowledge that moulds can be present on grains and tubers (55.25%) and understood that moulds can contaminate crops in the field and during storage (53.13%).
- The study found that fermented beverages offer a considerable energy supply owing to their carbohydrate and alcohol content, yet exhibit reduced levels of protein and fat.
- The primary minerals found were calcium, magnesium, and potassium, while iron, phosphorus, and zinc were present in smaller amounts.
- The results showed that 76.92% of homemade and 75% of industrial fermented beverages were contaminated with total aflatoxins, with levels exceeding the European Union’s maximum tolerable limit (≤4µg/L) in a significant proportion of the samples.
- In terms of AFB1, 15.38% of homemade and 25% of industrial fermented beverages exceeded the EU’s maximum tolerable limit (≤2µg/L).
- Some homemade samples also had higher alcohol content. Among the homemade samples, Kasiksi had the highest exposure to AFB1 (8.8±6.6 ng/kg b.w/day) and ethanol (2.46±1.85 mg/kg b.w/day), while the industrial sample Man4 had the highest ethanol exposure (4.83±2.40 mg/kg b.w/day) and the industrial sample Man8 had the highest overall exposure to AFB1 (85.5±35.9 mg/kg b.w/day).
- The MOE for AFB1 was found to be ≤1011.7, while for ethanol was found to be ≤818.2.
- Men were found to be more likely to be exposed to these substances.
The results showed a consistent decrease in AFB1 level in samples treated with probiotic strains.
- When L. bulgaricus and S thermophilus were used together, it led to the highest decrease in AFB1 levels (91.3%). Using L.. bulgaricus alone resulted in a reduction of 59.7%, while using S. thermophilus alone led to a reduction of 46.8%.
- It was observed that the sample with S. thermophilus had higher lactic acid content and lower pH. The sample with a combination of S. thermophilus and L. bulgaricus had the second highest increase in lactic acid content, followed by the sample with only L. bulgaricus.
- There was no statistically significant difference in acceptability scores between the experimental samples and the control sample.
- Based on the statistical analysis it was found a significant rise (p<0.000) in the average number of viable probiotics (specifically S. thermophilus, L. bulgaricus, and their co-culture) in the 2% S. thermophilus (St) samples. Conversely, there was a notable decline in the average number of viable probiotics in the 2% L. bulgaricus (Lb) samples.
- No coliforms were detected.
- No significant disparity (p>0.05) in the average number of mould and yeast observed in the various samples. This includes both the control samples and the samples containing different probiotics over the duration of the ten-day experiment. On average, the mould and yeast counts increased by up to 2 log units.
Higher consumption of both homemade and industrial fermented beverages was found to increase the likelihood of developing liver cancer due to decreased MOE levels for AFB1 and ethanol. These MOEs were found to be below the recognized safe threshold of 10,000, indicating a potential health concern. The MOE values were computed solely considering the intake of fermented beverages rather than the overall dietary exposure. This implies that the margin of exposure will be higher, and the potential risk associated with aflatoxin exposure will be more severe if calculated based on the total dietary exposure.
According to the findings and implications of the current research, it is strongly recommended that public health authorities in DR Congo should:
- Address the issue of fermented alcoholic beverages consumption as a significant health concern.
- Implement various strategies to assist individuals in reducing their alcohol consumption and enhancing their well-being. These measures include monitoring AFB1 and alcohol levels, labelling homemade fermented beverages, increasing taxes, limiting alcohol marketing, and addressing unrecorded alcohol consumption.
- Ensure the adoption of the Hazard Analysis and Critical Control Point (HACCP) framework within manufacturing facilities, in order to guarantee the absence of aflatoxin in products.
Furthermore, it is recommended that farmers and manufacturers:
- Should be educated on how to prevent fungal growth by reducing seed moisture content and implementing mitigation strategies.
- Should also explore detoxification strategies such as hot water treatment, ozonation, and probiotics during fermentation.
Additionally, it is recommended that researchers:
- Investigate the effectiveness of affordable probiotics to bind to aflatoxins on different fermented beverages made from various local ingredients.
- Conduct further research on the connection between AFB1, ethanol, and liver cancer.