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

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

Factors Associated with Acquisition of Human Infective and Animal Infective Trypanosome Infections in Domestic Livestock in Western Kenya

Trypanosomiasis is regarded as a constraint on livestock production in Western Kenya where the responsibility for tsetse and trypanosomiasis control has increasingly shifted from the state to the individual livestock owner. To assess the sustainability of these localised control efforts, this study investigates biological and management risk factors associated with trypanosome infections detected by polymerase chain reaction (PCR), in a range of domestic livestock at the local scale in Busia, Kenya. Busia District also remains endemic for human sleeping sickness with sporadic cases of sleeping sickness reported.In total, trypanosome infections were detected in 11.9% (329) out of the 2773 livestock sampled in Busia District. Multivariable logistic regression revealed that host species and cattle age affected overall trypanosome infection, with significantly increased odds of infection for cattle older than 18 months, and significantly lower odds of infection in pigs and small ruminants. Different grazing and watering management practices did not affect the odds of trypanosome infection, adjusted by host species. Neither anaemia nor condition score significantly affected the odds of trypanosome infection in cattle. Human infective Trypanosoma brucei rhodesiense were detected in 21.5% of animals infected with T. brucei s.l. (29/135) amounting to 1% (29/2773) of all sampled livestock, with significantly higher odds of T. brucei rhodesiense infections in T. brucei s.l. infected pigs (OR =  4.3, 95%CI 1.5-12.0) than in T. brucei s.l. infected cattle or small ruminants.Although cattle are the dominant reservoir of trypanosome infection it is unlikely that targeted treatment of only visibly diseased cattle will achieve sustainable interruption of transmission for either animal infective or zoonotic human infective trypanosomiasis, since most infections were detected in cattle that did not exhibit classical clinical signs of trypanosomiasis. Pigs were also found to be reservoirs of infection for T. b. rhodesiense and present a risk to local communities