**2.1. Awareness of aflatoxins**

fungal prevalence is rife. Unfortunately, some fungi, as part of their metabolic processes, synthesize mycotoxins (fungal toxins), that contaminate crops intended for human and animal consumption [2]. Ingestion of contaminated crops results in morbidity and mortality where tolerable levels are exceeded in food and feed [3, 4]. Associated health dysfunctions caused by aflatoxin ingestion include liver carcinoma and other hepatic dysfunctions, stunting in children and associated cognitive deficiencies, reduced immunity, and ailments associated with nutrient malabsorption due to disruption to villi architecture [5–7]. Acute aflatoxin ingestion can result in death. In livestock, including poultry, swine and fishes, listlessness, poor feed conversion ratio, reduced productivity are additional signs of aflatoxin ingestion [8, 9].

In addition to the negative health impacts caused by aflatoxins, aflatoxins also limit income generation. This is because the import of aflatoxin-contaminated produce above regulatory limits of importing countries is prohibited. Therefore, aflatoxin contamination has been responsible for depriving the sub-Saharan region of trade opportunities. Also, trading relationships have been marred by notifications of consistent aflatoxin contamination such as through the rapid alert system of the European Union (https://ec.europa.eu/food/safety/ rasff\_en). Moreover, economies of households within the sub-Saharan region are negatively affected because household income is diverted in addressing morbidity caused by aflatoxicosis (illness caused by ingestion of aflatoxins) termed disability adjusted life years (DALYs) [10]. This reduces availability of income for more economically advantageous ventures. Therefore, aflatoxin management is critical for the health and economy of sub-Saharan Africa However, it is reported that countries build social networks of trading relationships based on achievable mycotoxin limits [11]. For example, France is a trading partner with the UK, Spain and Netherlands (among others) which have similar total aflatoxin standards of 4 ng/g. Similarly, the USA is a trading partner with Mexico, Colombia, Dominican Republic (and others) which

Aflatoxin management is critical also because in addition to environmental reasons for aflatoxin exposure, infrastructural deficits, informal market structures and improper cultural habits can introduce additional aflatoxin-exposure risks [12]. Management strategies therefore, of necessity requires multi-dimensional approaches that mitigate risks from multiple sources such as contamination risks during crop development, during harvesting and post-harvest. This chapter discusses the approaches that are necessary for aflatoxin mitigation, and those that have been used for the management of aflatoxins in sub-Saharan Africa and progress made so far. Brief mention is also made of emerging strategies for aflatoxin management.

Aflatoxicosis may be broadly classified into **acute and chronic aflatoxicosis**. Acute aflatoxicosis refers to aflatoxin poisoning caused by ingestion of large doses of dietary aflatoxins. Chronic aflatoxicosis refers to aflatoxin poisoning caused by the ingestion of smaller amounts over extensive periods of time. Acute aflatoxicosis is severe often results in immediate fatalities. However, with chronic exposure the effects of exposure are cumulative, so exposure may be undetected in early stages because of its subsymptomatic nature. In sub-Saharan Africa, aflatoxin contamination has been reported by technical experts in academic journal

have similar total aflatoxin standards of 20 ng/g in maize.

110 Mycotoxins - Impact and Management Strategies

**1.2. Incidences of aflatoxicosis in sub-Saharan Africa**

Awareness of aflatoxins is critical to its management because information is the basis for initiating and sustaining measures to control aflatoxin exposure and associated health and economic implications. Awareness is a result of access to available information. This knowledge helps to inform the general public, health care practitioners, social workers, policy makers and other stakeholders on the risks of mycotoxins and control strategies necessary for prevention of aflatoxicosis and post-contamination management of contaminated crops, where prevention of contamination is not possible. There are different schools of thought regarding the way awareness creation is most effective [22, 23]. One school of thought suggests that the focus should be a top-bottom approach in terms of awareness creation about the problems of and solutions to aflatoxins without a bottom-up approach. The argument for this is that all that is required by the general public is to understand that there are differences in food quality, rather than the technical details of aflatoxins. This system will require that a food grading system is in place that enables the lay buyer to make financial decisions based on product differentiation. Furthermore, this may be more effective in a more organized market system where product differentiation on price and quality attributes are easily discernable. Another school of thought suggests that awareness creation should be a combination of topdown and bottom-up approaches. The argument for this is that education of the lay person on the risks associated with aflatoxicosis is necessary for behavioral changes towards crop management practices. This is important given the informal systems of trading that occur at the rural levels. Furthermore, as the systems of crop management are varied and so may require specific changes in practices suited to the customs of the regions.

So far, technical reports form many of the reports on aflatoxins and aflatoxin management. There are concerns that these reports are too technical and so the dire messages of aflatoxin exposure, and beneficial information on relevant interventions for aflatoxin management may not reach all stakeholders. Infographics and short documentations via policy briefs such as those by PACA and the International Food Policy Research Institute (IFPRI) are being developed. These are deliberate measures that that have been taken for technical information to be

Aflatoxin Management Strategies in Sub-Saharan Africa http://dx.doi.org/10.5772/intechopen.78784 113

Other regionals communities involved with raising awareness on aflatoxin management in the sub-Saharan African region include Permanent Interstate Committee for Drought Control in the Sahel/Comité permanent inter-État de lutte contre la sécheresse au Sahel (CILSS), Common Market for Eastern and Southern Africa (COMESA) and Economic Community of West African States (ECOWAS). Regional governments and government institutions communities assist with the development of regulatory schemes and their enforcement, aflatoxin testing, development of infrastructure and trade relationships, coordinating the access to appropriate technologies and infrastructure and establishment of trade relationships. Awareness within the communities is also important for proper decision-making. This is done through workshops and meetings wherein technical experts can communicate the

Private sector participation is key for aflatoxin management in the sub-Saharan Africa. This is particularly important because the private sector through demand-driven approach can influence the behaviors of growers, aggregators and important stakeholders towards adoption of aflatoxin management techniques. However, where there is no financial incentive or social incentive to change, growers' inertia to change can be high. The positive influence of the private sector in changing behaviors that promote aflatoxin accumulation have been demon-

Through a scheme, Pay for Performance (P4P), the WFP provided food relief in danger and conflict prone-regions of the world and aided those economies in improving crop quality and reducing aflatoxin contamination [25]. P4P requires grains for food relief. Due to the need to procure high quality food materials for disaster relief and a desire to promote crop production and so aid the economies within such regions, WFP influenced growers' behaviors for reduced aflatoxin contamination. This improved grain quality in the market and introduced grading systems. Examples of countries where this project covered include Zambia, Tanzania, Ghana, Burkina Faso, Democratic Republic of Congo, Ethiopia. The project was implemented

P4P operated via grassroot and growers' education on aflatoxin mitigation and measurement. Aflatoxin measurement in crops was done by using the blue box that contained aflatoxin test kits, moisture meter, sieves, in addition to other items. Due to the P4P scheme/initiative, WFP rejections of grains in market outlets decreased. WFP also paid a premium price above the

readily grasped by lay readers/audiences and policy makers.

technical details in simpler terms and respond to queries to clear doubts.

*2.1.1.2. Private-sector/commercial organizations*

strated. A few examples are discussed here.

between 2008 and 2013 [25].

**Example 1 – The World Food Program (WFP).**

#### *2.1.1. Multi-faceted aflatoxin-management strategies*

Current efforts made on aflatoxin awareness have been via multiple channels including policy briefs, regional reports, traditional media and social media reports, and word-of-mouth by various bodies such as regional government bodies and government institutions, privatesector and commercial organizations, extension services and farmers groups/community societies, and academic and research institutions among others.

#### *2.1.1.1. Regional governments and government institutions awareness*

The most notable regional bodies in sub-Saharan Africa regarding aflatoxin management is the Partnership for Aflatoxin Control in Africa (PACA), established under the Africa Union at the 7th Comprehensive Africa Agriculture Development Program (CAADP). PACA has raised awareness at regional and national levels through programs such as Pan-African workshops (these workshops have brought together scientific experts, lay people, policy makers, farmers and industries), policy briefs, coordination of sensitization and surveillance exercises at regional and national levels (http://aflatoxinpartnership.org). Through PACA's efforts, which are often in partnership with key organizations involved in aflatoxin management/mitigation, policies requiring the control of aflatoxins in foods is becoming mainstream. In recent years (from 2014), PACA has implemented the Africa Aflatoxin Information Management System) (AfricaAIMS) in pilot countries (including Senegal, The Gambia, Malawi, Nigeria, Tanzania and Uganda) to collate and harmonize data on aflatoxins [24]. This has been useful for assisting countries to make definitive and coordinated efforts in aflatoxin surveillance and discussions for aflatoxin management.

So far, technical reports form many of the reports on aflatoxins and aflatoxin management. There are concerns that these reports are too technical and so the dire messages of aflatoxin exposure, and beneficial information on relevant interventions for aflatoxin management may not reach all stakeholders. Infographics and short documentations via policy briefs such as those by PACA and the International Food Policy Research Institute (IFPRI) are being developed. These are deliberate measures that that have been taken for technical information to be readily grasped by lay readers/audiences and policy makers.

Other regionals communities involved with raising awareness on aflatoxin management in the sub-Saharan African region include Permanent Interstate Committee for Drought Control in the Sahel/Comité permanent inter-État de lutte contre la sécheresse au Sahel (CILSS), Common Market for Eastern and Southern Africa (COMESA) and Economic Community of West African States (ECOWAS). Regional governments and government institutions communities assist with the development of regulatory schemes and their enforcement, aflatoxin testing, development of infrastructure and trade relationships, coordinating the access to appropriate technologies and infrastructure and establishment of trade relationships. Awareness within the communities is also important for proper decision-making. This is done through workshops and meetings wherein technical experts can communicate the technical details in simpler terms and respond to queries to clear doubts.
