Human exposures to mycotoxins resulting in carcinogenic, neurotoxic and endocrine disreputability health outcomes warrant their monitoring in food systems. This meta-analysis was conducted to determine the occurrence and health risk implications of zearalenone, an abundant myco-estrogen in grains and cereal-based foods across African communities. Keywords; “adverse health", "cereals", "zearalenone", and "Africa" were used to screen published articles from Google Scholar, CrossRef, PubMed and Scopus databases and filtered to obtain 36 relevant articles covering 53 studies. Zearalenone concentrations were statistically converted to weighted averages and effect sizes, and its frequency of occurrence determined. Probabilistic dietary exposures were run using zearalenone concentrations, masses of cereal consumptions (from WHO/GEMs database) and consumers' body weight (from EFSA). Exposures were simulated at 100,000 iterations, benchmarked against the regulatory PMTDI (0.25 μg/kg) and quantified as hazard quotient (HQ) to describe risk of adverse health outcomes. The results presented zearalenone concentrations ranging from 0.90 to 1032 μg/kg and high prevalence in rice and rice-based products (75%). Simulated modal and 95th percentile zearalenone exposures ranged respectively from 1.20×10-4 to 1.49×10-3, and 0.030 to 0.494 μg/kg(bw)-day. Infants recorded the highest modal (1.780 μg/kg(bw)-day) and top 5% ( 95th percentile) exposures (0.494 μg/kg(bw)-day) which exceeded the regulatory threshold and consequently presented risk (HQ>1). In older age groups, 95th percentile exposures ranked in descending order as: adult females (0.037 μg/kg(bw)-day)>elderly group (0.033 μg/kg(bw)-day)>adult males (0.030 μg/kg(bw)-day). Infants were more vulnerable to risks arising from zearalenone contaminations and exposures. They are very likely to be exposed to this mycotoxin that exhibits estrogenic traits through out their lifetime and thus, concerted mitigation strategies for zearalenone must be encouraged to control risk among this age group.

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