Comprehensive assessment of maize aflatoxin levels in Eastern Kenya, 2005-2007.

Background: Aflatoxin, a potent fungal toxin, contaminates 25% of crops worldwide. Since 2004, 477 aflatoxin poisonings associated with eating contaminated maize have been documented in Eastern Kenya, with a case-fatality rate of 40%.

Objective: We characterized maize aflatoxin contamination during the high-risk season (April-June) after the major harvests in 2005, 2006 (aflatoxicosis outbreak years), and 2007 (a non-outbreak year).

Laboratory epidemiologist: skilled partner in field epidemiology and disease surveillance in Kenya.

Although for over 20 years the Field Epidemiology Training Programs (FETPs) have provided a model for building epidemiology capacity in Ministries of Health worldwide, the model does not address laboratory training and its integration with epidemiology. To overcome this, Kenya added a laboratory management component in 2004, creating the first field epidemiology and laboratory training program (FELTP) to train both medical and laboratory epidemiologists. Laboratory management and epidemiology candidates were recruited from among degree-holding scientists at the Ministry of Health and trained in both applied epidemiology and laboratory management using a combination of short courses and extensive field placements.