Mycotoxin contamination in Malawi: A systematic review of progress and trends in contamination, knowledge, attitude, and practices

Summary

This review examines mycotoxin (toxic mold) contamination in Malawi and found that most people—farmers, traders, and health workers—don’t know about these dangerous substances or how to prevent them. Although groundnuts and maize are well-studied, other commonly eaten foods like dried fish and mushrooms have been largely ignored in research. Despite years of efforts to educate communities, awareness remains critically low at about 24.5%, and poverty often forces people to eat contaminated food because it’s cheaper.

Background

Mycotoxin contamination poses a persistent threat to food safety, public health, and agricultural development in Malawi. Factors such as adverse climatic conditions, inadequate infrastructure, weak regulatory enforcement, and limited public awareness create an enabling environment for widespread contamination. Despite national initiatives like the Malawi Program for Aflatoxin Control (MAPAC), a consolidated review of contamination trends and intervention effectiveness remains absent.

Objective

This systematic review assessed 36 peer-reviewed and grey literature sources published between 2009 and 2025 to evaluate mycotoxin contamination prevalence, geographic distribution, knowledge-attitudes-practices (KAP) among food value chain stakeholders, and the effectiveness of existing interventions in Malawi.

Results

Analysis of 8,254 samples and 5,296 respondents revealed critically low awareness (24.5% national average) with no improvements between 2012-2025. Aflatoxins dominated research (90% of studies), primarily in maize and groundnuts (75.5% of samples). Other high-risk foods including dried fish, mushrooms, and vegetables remain understudied. Misconceptions persist regarding mold-health risks, and socioeconomic constraints drive consumption of contaminated foods.

Conclusion

Despite various interventions and institutional efforts, mycotoxin contamination remains a critical threat to Malawi’s food safety and public health. Progress has been limited by persistent knowledge gaps, weak regulatory enforcement, research imbalances favoring certain commodities, and socioeconomic pressures. A coordinated multi-sectoral approach strengthening surveillance, regulatory compliance, and stakeholder education is urgently needed.
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