Examining the structure of awareness and perceptions of groundnut aflatoxin among Ghanaian health and agricultural professionals and its influence on their actions

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Abstract

This study uses a modified health belief model (HBM) within a socio-economic framework to evaluate the influence of awareness and knowledge on actions to reduce aflatoxin (AF) contamination in groundnuts (peanuts). Data were collected in 2002 through a self-administered questionnaire from a sample of 367 individuals. Socio-economic factors affecting perceptions, awareness, knowledge, and action were examined using structural equation modeling. The perceived benefits of good quality groundnuts and/or groundnut products were the most important determinants of awareness and knowledge of AF among agricultural and health professionals in Ghana. Awareness, in turn, had a significant causal effect on the professionals’ decisions to take actions to increase the level of awareness of AF in the society. Demographic factors, such as gender and level of education significantly influenced knowledge of AF and the perception of the benefits of good quality groundnut. Type of profession had a significant influence on awareness and perceived seriousness of the AF problem. Education was a significant determinant of awareness of AF in groundnuts. The study generates important information for policy decision making when considering resource allocation to reduce food contamination in developing economies.

Introduction

Substantial crop losses occur between harvesting and final utilization of many agricultural products. The losses of grains and oilseeds have been estimated at about 20–50% (CAB International, 2002). Though it has been estimated that post-harvest losses of crops are greater than the improvements made in primary production, research on the role of post-harvest losses on food supply, food security, human nutrition, and health has been given little attention until recently. It has been realized by international organizations and donor agencies that food contamination by microorganisms, including molds, is a major cost of post-harvest, and a health and economic hazard. Aflatoxins (AFs) are a group of extremely toxic metabolites produced by molds, specifically the fungi Aspergillus flavus and Aspergillus parasiticus (Gourama and Bullerman, 1995, CAST, 2003). Williams et al. (2004) have indicated that over 5 billion people in developing countries worldwide are at risk of chronic exposure to AFs. A recent incident in Kenya when about 125 people died from consuming AF-contaminated corn in 2004, followed by another outbreak in 2005, is a case in point (CDC, 2004, Strosnider et al., 2006). Strosnider et al. (2006) indicated that AF risks can be reduced through information diffusion through awareness campaigns. Hence, we use AF here to emphasize the importance of a holistic socio-economic model development for policy analysis to reduce the risk of food contamination in developing economies. We proceed with a theoretical framework, methods, a results section, and finally discussion and conclusion.

AF contamination of grains inflicts annual losses of more than $750 million in Africa, and is a major economic and health problem for Ghana (Cardwell et al., 2004). It has been noted that over $100 billion of exported commodities all over the world are susceptible to mycotoxin contamination. AF is also associated with several health conditions including jaundice, liver cancer, and even death (Jolly et al., 2007). Given the economic magnitude of losses inflicted by AF-contaminated grains and oilseeds, and that these losses can be reduced by education, awareness, and behavioral changes in post-harvest handling of these products, we design an inclusive socio-economic model to unravel the relationships between perception, awareness, and behavior toward policy development to mitigate post-harvest crop losses due to AF.

Contamination at successive stages in growing and storage of crops results in destruction and downgrading of grains and oilseeds as well as in depression of their nutritional value. Prevention of AF contamination of crops generates costs and reduces market competitiveness. The Food and Drug Administration (FDA) has regulated the levels of AF in human foods to not more than 20 parts per billion (ppb). The maximum limit imposed by the Food and Agricultural Organization (FAO) of the United Nations in 1995 was 30 ppb (FAO, 2002). The European countries have recently imposed a 4 ppb on peanuts and 2 ppb for corn (Otsuki et al., 2001). These limits, imposed on the levels of food contamination, are bound to affect trade flows to a level that will aggravate the worsening food security problems existing in the developing world.

Staples such as maize and groundnuts are contaminated with levels of AF that far exceed the 20 ppb contamination level considered safe by the World Health Organization (WHO) and the FAO (WHO, 1998). AF contamination in groundnuts and grains is fostered by hot and humid conditions and by improper production, harvesting, post-harvest handling, and storage practices. AF is perceived to have two major health risks, and a third, lesser-known set of toxic effects should be added. AFs are carcinogenic and the risk of hepatocellular carcinoma in humans, especially in people with hepatitis B infection (Omer et al., 1998), is a function of cumulative exposure. Chronic aflatoxicosis with no clear symptoms occurs when sustained exposure at sub-lethal doses occurs, and is characterized by suppression of immunity and nutritional status as reviewed by Williams et al. (2004) and Jiang et al. (2005). AF is ubiquitous and cannot be completely eliminated from the diet; however, AF levels in staples can be reduced to an acceptable level for humans and animals at reasonable costs by appropriate management practices.

The Ghanaian economy depends heavily on agriculture. In 2000, Ghana produced an estimated 1,034,500 metric tons of corn and 190,000 metric tons of groundnuts (FAO, 2002). Ghanaians consume maize and groundnuts about three to four times per week (Awuah et al., 2001). Unfortunately, the basic staples they consume (and the excess traded in urban and rural markets) are poorly handled and stored prior to marketing and are heavily contaminated by AFs (Awuah and Kpodo, 1996). Bearwood (1964) surveyed market groundnut in Accra and reported that 69% of the samples tested were highly contaminated with the toxin. Mintah and Hunter (1978) also analyzed 80 market groundnut samples from the Accra area and indicated that several of the samples, especially those emanating from the more humid Volta region, had AF levels that exceeded the 30 μg/kg per kernel hazard level recommended by WHO/FAO (Mintah and Hunter, 1978, Kpodo, 1996, Awuah, 2000a, Awuah, 2000b). In spite of its omnipresence and its deleterious health and agricultural economic importance, few agriculturists or health professionals are aware of the health risks associated with AF-contaminated foods. These professionals are charged with policy formulation which involves resource allocation to reduce the problem of AF contamination; yet they are unaware of its economic and health risks.

In this study, we examine Ghanaian agriculturists and health professionals’ awareness and knowledge of AF contamination of groundnuts (peanuts) and the associated health risks. The purpose of the study is to assess the scale dimensional structure of Ghanaian's policy makers’ beliefs about AF in groundnuts, their level of awareness and knowledge, and actions that may enhance their awareness of the problem. The role of perceptions, awareness, and knowledge in policy decision-making processes are analyzed to determine factors that can be manipulated at the policy level to produce a good quality groundnut.

Section snippets

Theoretical framework

A large number of people in both developing and developed countries is not aware of risks associated with contaminated foods (Siegrist and Cvetkovich, 2000). Fearing this lack of information, most people try to access knowledge about food safety risks from available experts. These experts often differ in levels of knowledge and interests in food safety issues (Fischoff et al., 1978). Not only is there a transaction cost in the search for knowledge about food safety, but the transaction costs

Sample

Data for this study were collected in 2002 through a survey administered to 367 health, agricultural, and other professionals in all 10 regions of Ghana. An attempt was made to interview individuals who work at a decision-making level in health and agriculture and are considered food safety and health issue experts, and are responsible for the diffusion of information on food risks.

Survey instrument

Respondents completed the survey instrument from which we gathered information on their socio-economic

Results

Of the respondents interviewed, 257 (70%) were agriculturists, 74 (20%) were health professionals, and 36 (10%) were other scientists and administrative personnel. Men constituted 80% of the respondents and women 20%. The average age of respondents was 41 years, with the majority (62%) being between 36 and 49. More than 50% of the respondents reported having at least a bachelors degree, whereas approximately 49% had a certificate or diploma level of education. A large number of respondents (42%)

Discussion and conclusions

The paper examines the factors likely to affect awareness, knowledge, perceptions, and actions needed to reduce the level of contamination of groundnuts. Three particular constructs appeared to adequately measure administrators’ perceptions of AF problems. They include perceived seriousness, perceived barriers, and perceived benefits.

A distinct and important finding of the study involves the relationships between perceived benefits of reducing AF contamination of groundnuts and awareness, and

Acknowledgements

This study was funded by the Peanut Collaborative Research Support Program, USAID Grant No. LAG-G-00-96-90013-00, and supported by Auburn University and the Kwame Nkrumah University of Science and Technology. The authors would like to thank the Ministry of Agriculture and Forestry Ghana for their support.

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