Complementary feeding in Kongwa, Tanzania: Findings to inform a mycotoxin mitigation trial

Modeling maize aflatoxins and fumonisins in a Tanzanian smallholder system: Accounting for diverse risk factors improves mycotoxin models

Human exposure to mycotoxins is common and often severe in underregulated maize-based food systems. This study explored how monitoring of these systems could help to identify when and where outbreaks occur and inform potential mitigation efforts. Within a maize smallholder system in Kongwa District, Tanzania, we performed two food surveys of mycotoxin contamination at local grain mills, documenting high levels of aflatoxins and fumonisins in maize destined for human consumption. A farmer questionnaire documented diverse pre-harvest and post-harvest practices among smallholder farmers. We modeled maize aflatoxins and fumonisins as a function of diverse indicators of mycotoxin risk based on survey data, high-resolution geospatial environmental data (normalized difference vegetation index and soil quality), and proximal near-infrared spectroscopy. Interestingly, mixed linear models revealed that all data types explained some portion of variance in aflatoxin and fumonisin concentrations. Including all covariates, 2015 models explained 27.6% and 20.6% of variation in aflatoxin and fumonisin, and 2019 models explained 39.4% and 40.0% of variation in aflatoxin and fumonisin. This study demonstrates the value of using low-cost risk factors to model mycotoxins and provides a framework for designing and implementing mycotoxin monitoring within smallholder settings.

Processing complementary foods to reduce mycotoxins in a medium scale Tanzanian mill: A hazard analysis critical control point (HACCP) approach

Designing and implementing processing procedures for producing safe complementary foods in dynamic and unregulated food systems where common food staples are frequently contaminated with mycotoxins is challenging. This paper presents lessons about minimizing aflatoxins (AF) in groundnut flour and AF and/or fumonisins (FUM) in maize and groundnut pre-blended flour for complementary feeding in the context of a dietary research intervention in rural Tanzania. The flours were processed in collaboration with Halisi Products Limited (Halisi), a medium scale enterprise with experience in milling cereal-based flours in Arusha, Tanzania. Using a hazard analysis critical control point (HACCP) approach for quality assurance, two critical control points (CCPs) for AF in processing the pre-blended flour were identified: 1) screening maize before procurement, and 2) blending during the processing of each constituent flour. Blending of maize flour was also identified as a CCP for FUM. Visual inspection during screening and sorting were identified as important control measures for reducing AF, but these steps did not meet the criteria for a CCP due to lack of objective measurement and verifiable standards for AF. The HACCP approach enabled the production of low AF (<5 μg/kg) and FUM (<2 μg/g) flours with low rejection rates for the final products. The paper presents practical lessons that could be of value to a range of commercial processors in similar low- and middle-income contexts who are keen on improving food quality.

Validation of a HACCP community-based infants' complementary food safety assurance method in cash crop producing communities in Gedeo zone, Southern Ethiopia

A method based on a hazard analysis critical control point (HACCP)-based standard operating procedure (SOP) has been developed and implemented in community-based (CB) production of complementary foods (CFs) in agrarian regions in rural Ethiopia. The objective of this study was to validate the method in another setup, more specifically in cash crop (coffee and khat) producing communities in Southern Ethiopia. A quasi-experimental study was employed for the method validation. Two villages in the Gedeo zone, Southern Ethiopia were selected and a total of 40 mother-child pairs, 20 in each village, were involved in the study. Sociodemographic data, knowledge, and complementary feeding practices were collected using pretested questionnaires. The training was given to each mother for 1 h about community-based CFs production and implementation of the method. Then, 30 CF samples were collected and the level of aflatoxins (AFB1, AFB2, AFG1, and AFG2) was determined using a validated method. The majority (77.5%) of the mothers understand the importance of complementary feeding and give it to their infants beyond 6 months. Nearly two-thirds (62.5%) of the mothers had knowledge about the health impacts of aflatoxins, but the remaining 37.5% lacked awareness about the health risks of aflatoxins. Mothers were very well-motivated for the training and they promised to implement the knowledge and skill gained from the training for improving the nutritional status of their children. Overall, 23.3% of the CFs were contaminated by aflatoxins. AFB1 and AFG1 were detected in 6.7 and 16.7% of the CF samples, respectively. In cash crop-producing communities around the country, the HACCP-based SOP is easily validated in CB CFs production. Therefore, a scaleup of the method at the national level and beyond is recommended.