Aflatoxins and fumonisins in sorghum eaten in Ethiopia
What it found
In adults in Ethiopia, estimated fumonisin intake from sorghum injera stayed below the level the FAO and WHO treat as a health concern, while estimated aflatoxin intake was high enough to flag a possible health concern.
The work used measured mycotoxin levels in sorghum grain and national food intake data, not measurements in people.
What they found
Animal and lab studies
Contamination in samples
Fumonisins were found above the limit of detection in 32 of 240 sorghum samples (13.3 percent) and aflatoxins in 5 samples (2.1 percent). Two samples (0.8 percent) went over the FAO and WHO limit of 10 ng/g for aflatoxin, at 18.34 and 29.25 ng/g, while no sample went over the fumonisin limit.
Other findings
Fumonisin exposure
Estimated fumonisin intake ranged from 0.10 to 14.78 ng/kg body weight per day in the Amhara region and from 7.47 to 299.16 ng/kg body weight per day nationally. Both ranges stayed below the FAO and WHO limit of 2000 ng/kg body weight per day, which the authors say means the related public health risk is negligible.
Aflatoxin exposure
Estimated aflatoxin intake ranged from 0.007 to 0.267 in the Amhara region and from 5.08 to 300.00 nationally. Most results in the Amhara region and all results nationally fell below the margin of exposure value of 10000, which the authors say indicates a potential health concern.
Liver cancer estimates
The estimated number of hepatocellular carcinoma cases linked to aflatoxin exposure ranged from 0.0003 to 0.017 per 100,000 people per year in the Amhara region and from 0.181 to 8.47 nationally. For lifetime exposure, the authors estimated 0.2 to 11.5 new cases per million people in the Amhara region and 122.7 to 5742.66 per million nationally.
Disability-adjusted life years
For lifetime aflatoxin exposure, the related disability-adjusted life years ranged from 0.2 to 11.05 per million in the Amhara region and 117.69 to 5489.98 per million nationally. Across Ethiopia's 125 million people in 2022, the authors estimated a total of 216.96 to 10,121.64 disability-adjusted life years.
What drove exposure
A sensitivity analysis showed that changes in how much sorghum people ate had a bigger effect on aflatoxin exposure than changes in aflatoxin levels in the grain or body weight. The authors say aflatoxin exposure was driven more by sorghum intake than by aflatoxin contamination.
What the authors conclude
“Health concerns have been related mainly to sorghum intake. Therefore, dietary intervention at consumers' level is recommended to reduce aflatoxin exposure.”
Also in their conclusions
- They say fumonisin exposure was below the level considered a health concern, but aflatoxin exposure is a priority for risk management.
- They recommend dietary intervention at the consumer level to reduce aflatoxin exposure, along with integrated preventive strategies across the sorghum value chain covering production, storage and handling.
- They also say that since sorghum is a staple food, reducing its consumption may be difficult or inappropriate, and a more effective strategy would be a code of practice to reduce aflatoxin contamination in the local food supply chain.
How it was done
The authors say studies on mycotoxin exposure from sorghum in Ethiopia and the related public health risk estimates are rarely available, and that a quantitative estimate of the health burden is more useful to policymakers than exposure information alone.
They used fumonisin and aflatoxin levels measured in 240 sorghum samples grown in northwest Ethiopia in the 2022 season, plus published levels for the national estimate, and combined these with sorghum intake data from 944 women in the Amhara region and 10,006 women nationally. They ran computer simulations to estimate daily intake for adults and then estimated liver cancer cases and disability-adjusted life years.
What it can’t tell you
- This work estimates exposure from food intake data and mycotoxin levels in grain, not from measurements in people's bodies, so it cannot show how much aflatoxin or fumonisin individuals actually took in.
- The national estimates used a worst-case assumption that the average levels of each aflatoxin occurred in the same samples, which the authors say could overestimate exposure and disease burden.
- The lifetime risk estimates assumed people were exposed to the same level throughout their lives, which the authors say is not realistic.
Who paid
- Conflicts
- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
- Authors work at
- Wageningen University and Research, the Netherlands; Bahir Dar University, Ethiopia; International Food Policy Research Institute, USA
The paper
- Title
- Exposure and disease burden of fumonisins and aflatoxins from sorghum consumption in Ethiopia
- Type
- Study
- Evidence
- Animals and lab studies
- Summarised from
- Full text
- Licence
- CC BY. Words in quotation marks are the authors’; the rest is our summary.
- Cite
- Sadik JA, Fentahun N, Brouwer ID, Tessema M, Fels-Klerx HJV (2026). Exposure and disease burden of fumonisins and aflatoxins from sorghum consumption in Ethiopia. Regulatory toxicology and pharmacology. doi:10.1016/j.yrtph.2025.105966Free full textPubMed 41101517DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error