Food Safety Risks from Mycotoxin in Sierra Leone Based on Multi Stakeholder Knowledge Attitudes and Practices

Abstract Chronic dietary exposure to mycotoxins poses a major food safety threat in sub-Saharan Africa, yet data on stakeholder awareness in Sierra Leone remain extremely limited. This study assessed knowledge, attitudes, and practices (KAP) related to mycotoxin contamination among consumers, farmers, traders, and health professionals. A cross-sectional survey was conducted in November 2025 across five representative districts of Sierra Leone. Probability sampling yielded 426 household consumers, while purposive sampling identified 113 key informants (45 farmers, 35 traders, 26 health professionals, 6 policy makers). Structured questionnaires captured demographic data, consumption patterns, storage practices, and awareness of mycotoxin risks. Data were analyzed using descriptive statistics and chi-square tests. Only 4.2% of consumers recognized the term "mycotoxin," and just 39.8% knew that moulds can produce harmful substances. Awareness increased significantly with education (3.0% among those with no formal schooling vs. 17.2% with tertiary education; p < 0.01). Fewer than half (46.1%) believed mouldy food causes health problems, with most associating risks only with mild gastrointestinal symptoms. Risky practices were widespread: 61% cut off mouldy parts and consumed the remainder, 63% washed contaminated food, 68% re-dried mouldy items, and 64% fed mouldy food to animals. Only 28% discarded mouldy food immediately. Among farmers, 24.4% had heard of mycotoxin-related diseases; among health professionals, 15% recognized the term, and 85% rated mycotoxins as a "very significant" food safety issue after being informed. Only 23% of health workers had received training on mycotoxins. Storage practices were suboptimal: 42% used woven bags, 38% used plastic buckets, and only 6–7% used airtight containers. Sierra Leone faces a critical gap in mycotoxin awareness and safe food handling practices. Urgent national awareness campaigns, integration into extension and health services, improved drying and storage infrastructure, and robust regulatory frameworks are essential. Coordinated public health interventions and policy reforms will be pivotal to reducing exposure, safeguarding nutrition, and protecting vulnerable populations.