Prevalence and Concentration of Aflatoxin M1 in Mother Milk: A Meta-analysis, Meta-regression, and Infants' Health Risk Assessment

Breast milk is a complete and nutritious food for newborns and infants, but it may be contaminated with Aflatoxin M-1 (AFM(1)), which endangers consumers' health. Several studies from various regions have determined the concentration and prevalence of AFM(1) in mother milk. In this study, an attempt was made to meta-analyze the concentration and prevalence of AFM(1) and estimate the health risk of infants. The concentration and prevalence of AFM(1) in the countries subgroup were meta-analyzed in the random effects model (REM), and also the effect over time on the prevalence of AFM(1) was determined by meta-regression. Finally, the human risk in infants was estimated via the margin of exposure (MOES) in different countries. The five countries with the highest prevalence of AFM(1) in mother milk were observed in Jordan (100.00), Tanzania (100.00), Mexico (97.00%), Lebanon (93.69%), and Colombia (90.00%). The pooled prevalence of AFM(1) in mother milk was 54.48%, 95% CI (42.99-65.73). The five countries with the highest concentration of AFM(1) in mother milk were observed: Egypt (570 mu g/l), Sudan (413 mu g/l), Cameroon (315.00 mu g/l), Serbia (175 mu g/l), and Tanzania (70 mu g/l). The pooled prevalence of AFM(1) in mother milk was 6.00, 95% CI (5.80-6.90(. Except for Egypt, infants in other countries are at an acceptable health risk (MOEs > 10,000). Considering the unacceptable risk due to the consumption of milk containing AFM(1) in Egypt, it is suggested that programs be carried out to control the quality of mother milk.