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Abstract
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Before
The case for the association between aflatoxin exposure in children and stunting is still out. While the few studies that have looked at the association between stunting and aflatoxin exposure have found surprisingly large effects, the results remain inconclusive. The objectives of this study are to: (i) study the impact of reduced aflatoxin exposure on child growth and (ii) identify a package of storage technologies that will reduce aflatoxin contamination. We propose a three arm randomized control trial in which households with children under 2 years of age will be randomly allocated to an intervention group in which a package of storage technology and best practices are provided; an intervention in which maize is tested and contaminated maize is swapped; and a control group in which information on the health effects of aflatoxin and strategies to mitigate it are provided. Aflatoxin levels and stunting rates at baseline and follow up will be compared across the intervention groups to answer the following questions: Does reduced aflatoxin consumption, holding all else constant, improve child growth? What is the effectiveness of a package of low-cost, post-harvest and storage technologies and practices for reducing aflatoxin contamination in household maize stores?
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After
Whether the observed association between aflatoxin exposure and stunting in children is causal, and how exposure to this toxin can be mitigated, are open questions. This study comprises a three-arm randomized controlled trial designed to answer both questions. Within 71 randomly selected maize-growing villages of Meru and Tharaka-Nithi counties of Kenya, households that included a pregnant woman or child under 2 years of age were recruited. Villages were randomly assigned to, a post-harvest technology intervention group, an exposure reduction intervention group, or a comparison group. Within the post-harvest group, prices for an aflatoxin mitigation technology were randomly varied across households, as was the opportunity to receive a price incentive for safe stored maize. Primary outcomes in the post-harvest technology sub-study are adoption of the technology and aflatoxin levels in stored maize. Primary outcomes in the exposure reduction sub-study are blood aflatoxin levels in children and child linear growth (LAZ).
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Trial End Date
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Before
October 31, 2016
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After
March 31, 2017
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Last Published
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Before
December 30, 2014 04:22 PM
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After
November 23, 2016 01:46 PM
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Intervention End Date
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Before
September 30, 2016
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After
October 31, 2016
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Field
Primary Outcomes (End Points)
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Before
Incidence of household maize stores with aflatoxin levels above 10 ppb; incidence of identification of aflatoxin albumin adduct in blood samples; child anthropometrics
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After
Incidence of household maize stores with aflatoxin levels above 10 ppb; willingness to pay for the offered post-harvest technology; incidence of identification of aflatoxin albumin adduct in blood samples; child anthropometrics
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Field
Experimental Design (Public)
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Before
We propose a three arm randomized control trial in which households with children under 2 years of age will be randomly allocated to an intervention group in which a package of storage technology and best practices are provided; an intervention in which maize is tested and contaminated maize is swapped; and a control group in which information on the health effects of aflatoxin and strategies to mitigate it are provided. Aflatoxin levels and stunting rates at baseline and follow up will be compared across the intervention groups to answer the following questions: Does reduced aflatoxin consumption, holding all else constant, improve child growth? What is the effectiveness of a package of low-cost, post-harvest and storage technologies and practices for reducing aflatoxin contamination in household maize stores?
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After
We propose a three arm randomized control trial in which 71 villages will be randomly allocated to an intervention group in which a package of storage technology and best practices are provided (post-harvest group); an intervention in which maize is tested and contaminated maize is swapped (aflatoxin exposure reduction group); and a control group in which information on the health effects of aflatoxin and strategies to mitigate it are provided. Within the post-harvest group, prices for an aflatoxin mitigation technology were randomly varied across households, as was the opportunity to receive a price incentive for safe stored maize.
The post-harvest sub-study is designed to investigate the effectiveness of a package of low-cost, post-harvest and storage technologies and practices for reducing aflatoxin contamination in household maize stores, and farmers' willingness to pay for such a technology, with and without a price incentive for aflatoxin-safe grain. The exposure reduction sub-study is designed to answer the following research question: does reduced aflatoxin exposure, holding all else constant, improve child growth?
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Field
Planned Number of Observations
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Before
1500 Households
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After
1852 households
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