Community knowledge and awareness of aflatoxin in dietary staples in rural Busia County, Kenya: a mixed methods study

Abstract

Aflatoxins are an important food safety challenge globally and in Kenya. Understanding a community’s knowledge, perception and practices is instrumental to improvement of aflatoxin control measures. Creating awareness on the causes of contamination and mitigation options could improve aflatoxin mitigation. This study aimed to map out dietary staples, establish drivers of food choices, describe knowledge and perceptions on aflatoxin and post-harvest grain management practices and use among the communities in Busia County in order to guide future evidence-based aflatoxin prevention and public health interventions. A household survey was conducted in 40 villages, and participants were selected using stratified systematic sampling in three sub-counties in rural Busia County. The survey was complemented and triangulated with a qualitative study component. Focus Group Discussions with sixty women and sixteen semi- structured interviews with nine men and seven women were conducted. Both descriptive and statistical analysis of data were performed. The results showed variability in household diversity scores and maize was observed as the community staple. While both younger and older participants were able to identify spoilt grains, they demonstrated limited knowledge and awareness of aflatoxin. Participants were not aware that seemingly clean grains could be colonized by aflatoxin as they only associated spoilage with discoloration and bitter taste of flour. Study participants were also not aware of the aflatoxin pathways to exposure as they used the spoilt grains in feeding chicken, making animal feed and local brew. Appropriate disposal methods of aflatoxin contaminated food were not known. The knowledge gap was attributed to lack of awareness creation and sensitization by the relevant government ministries. For effective control and prevention of aflatoxin contamination, farmers and traders need to be aware of the causes of aflatoxin contamination of grains, available mitigation options and health risks attributable to aflatoxin exposure in order to self-regulate. Ministries of health and agriculture, through their public health officers, community health workers and agricultural extension officers respectively need to collaborate and spearhead awareness creation among communities and institute food surveillance systems in Busia County.