LAUSR

Abstract The aims of this study were to assess the state of knowledge and perceptions regarding aflatoxin contamination among frontline workers in direct contact with small holder farming households in Malawi as well as among the households themselves. The study first investigated and documented demographic profiles of agriculture extension workers (n = 22) and frontline health workers (n = 161) both from Ntchisi district and small holder farming households (n = 915) from Dedza, Balaka and Mzimba districts. Structured questionnaires were administered to document knowledge and perceptions. Majority of the respondents in Ntchisi were frontline nutrition and health workers as follows: care group promoters (31.7%), cluster leaders (51.9%) and health surveillance assistants (4.4%). Only 12% of the respondents were agriculture extension officers. Among frontline workers, using factor analyses, factors highly associated with the knowledge on domestic management of aflatoxin contamination and the impact of aflatoxin contamination on child linear growth and health in general were most prominent. Whereas, their knowledge of pre & post-harvest practices that pre-dispose crops to aflatoxin contamination and impact of aflatoxin contamination on trade and income losses was relatively low. On the other hand, among small holder farming households, lowest knowledge was related to occurrence of aflatoxin contamination pre and post-harvest. Highest knowledge was observed on issues around loss of income due to aflatoxin contamination. Across all districts over 50% of surveyed respondents reported that they perceived aflatoxin contamination severity as low. Majority of the households (>50%) did not perceive aflatoxin contamination as a problem that could be controlled. This is the first study to investigate knowledge, attitudes, practices and perceptions on aflatoxin contamination among a combination of agriculture extension officers and frontline health workers in parallel with the households they usually are in contact with. The current investigation is crucial because it elucidates knowledge gaps in aflatoxin critical control across agriculture extension, health workers and the small holder farming households. This is especially crucial among agriculture extension workers and frontline health workers as they have direct contact with households and therefore serve as an important source of information that could influence behavior change.