MAICE

Mitigating Aflatoxin exposure for Improving Child growth 

Eastern Kenya 

Collaborators: Vivian Hoffmann and Jef Leroy 

2013-2016. American Economic Association RCT Registry # AEARCTR-0000105

Aflatoxins are food-borne mycotoxins that contaminate groundnuts, maize and other cereals. Chronic consumption can lead to liver cancer, and high levels of acute consumption can lead to aflatoxicosis, which is untreatable and fatal. Lacking formal market regulation, many low-income countries face significant public health risks from this contaminant. The issue is particularly critical in Eastern Kenya, a hotspot of aflatoxin, which faced an outbreak in 2004 involving more than 125 deaths. Recent research has suggested an association between aflatoxin exposure and child stunting. We conducted a cluster-randomized controlled trial to test whether a causal link exists. We exogenously lowered the level of aflatoxin exposure for a randomly selected group of 500+ children from a few months before birth until their 2nd birthday, and compared their growth outcomes with a comparably sized control group. 

In addition, we tested the marketability of a technology that aids small-scale producers in reducing aflatoxin contamination in their own-produced and stored maize. We compare the willingness to pay for this technology between market and subsistence producers under various cost subsidies and maize price incentive schemes. We further consider the costs and health benefits of this and other aflatoxin-reducing technologies and compare them against benchmarks of cost-effectiveness for public health interventions.