www.nature.com/scientificreports
OPEN Survey of knowledge, and attitudes 
to storage practices preempting 
the occurrence of filamentous fungi 
and mycotoxins in some Ghanaian 
staple foods and processed 
products
Nii Korley Kortei 1*, Sandra Badzi 1, Salifu Nanga 2, Michael Wiafe‑Kwagyan 3, 
Denick Nii Kotey Amon 3 & George Tawia Odamtten 3
Mycotoxigenic fungi can infect and produce potent mycotoxins in foodstuffs prior to harvest, during 
harvest (field fungi), and in storage after harvest (storage fungi), which when ingested, can result in 
adverse health effects. This study was aimed at assessing the knowledge, attitudes, and practices 
adopted by the Ghanaian populace to help mitigate the occurrence of molds and mycotoxins in foods. 
A cross‑sectional survey involving a structured questionnaire was conducted with 642 respondents 
from twelve regions of Ghana. Descriptive statistics and analyses of variance were calculated. 
Correct Classification Rate (CCR) was measured to assess the utility of a logistic regression model. 
The results of the study showed that the majority of 299 (46.6%) of the respondents were between 
the ages of 18–25. Age and educational level were related to knowledge about the occurrence of 
fungi and mycotoxins in foods (p < 0.05). More than half the respondents, 50% indicated that they 
knew of aflatoxins as a major mycotoxin present in food. Higher education directly influenced on the 
knowledge of mycotoxicosis and the management of stored food to present intoxication by fungal 
metabolites. 502 (32.9%) knew that consuming foods with toxins could cause stomach aches. The 
most commonly consumed food commodity despite the presence of visible growth of fungi was 
bread (35.3%). The average KAP score for knowledge showed that, out of 100%, there was adequate 
knowledge (63.8%) among the members of the Ghanaian populace. Favorable environmental 
conditions of high humidity (> 85% ERH) and temperature (> 28–32 °C) enhance the proliferation of 
fungi in most foods and the attendant production of mycotoxins such as aflatoxins, ochratoxins, and 
fumonisins are associated with several severe human and animal health conditions; mycotoxicosis was 
associated with high fever, pain, vomiting, suppression of immunity, cancer, etc. when these foods are 
consumed on regular basis for a prolonged length of time. Future examination of the food items used 
for the School Feeding Programme in Ghana will offer opportunities to examine the risks of feeding 
youth with fungal‑contaminated food preparations from providers.
Fungal contamination of foodstuffs and agricultural produce is a prevailing global problem, particularly in devel-
oping countries. The prevailing hot and humid tropical environmental climate conditions support the growth 
of mycobiota both in the field and in s torage1. Unfortunately, the growth of fungi causes not only spoilage but 
depreciates food quality and reduces food security. The ubiquitous nature of fungi and their airborne spores 
enable them to thrive over a wide range of habitats including deserts, hyper-saline environments such as the sea, 
on rocky surfaces, etc. with varying climatic conditions of low and high t emperatures2.
1School of Allied Health Sciences, Department of Nutrition and Dietetics, University of Health and Allied Sciences, 
PMB 31, Ho, Ghana. 2School of Basic and Biomedical Sciences, Department of Basic Sciences, University of 
Health and Allied Sciences, PMB 31, Ho, Ghana. 3College of Basic and Applied Sciences, Department of Plant and 
Environmental Biology, University of Ghana, P. O. Box LG 55, Legon, Ghana. *email: nkkortei@uhas.edu.gh
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 1
Vol.:(0123456789)
www.nature.com/scientificreports/
The species of fungi causing mycotoxicosis are mainly in the genera of Aspergillus, Fusarium, and Penicillium, 
although others have also been implicated in causing mycotoxicosis in man when he ingests food contaminated 
by fungal toxins. Indeed, some mycotoxins cause diseases such as cancer (aflatoxins), and some damage vital 
organs such as the brain and nervous system, liver, and kidney to mention but a  few3,4. Of great concern to public 
health is the effect of mycotoxins on the fragile immune systems of adults and children alike, although infants, 
by virtue of their smaller body weight and less acid stomach, are more susceptible to mycotoxins than  adults5,6.
Indigenous farmers in Africa have devised the use of local plant parts to reduce fungal and insect infesta-
tion in stored staple f oods7,8. However, fungal toxins continue to take a toll on the health of the populace. It is 
presumed that the lack of knowledge of the conditions which predispose food to fungal intoxication is not well 
understood by both the farmers and the populace although the phenomenon has been demonstrated by scientists 
in the pertinent l iterature9.
It is well known that aflatoxins are potent hepatotoxic, teratotoxic, mutagenic, and carcinogenic mycotoxins 
produced by members of the Aspergillus section Flavi namely A. flavus, A. parasiticus, A. nomius, A. pseudono-
mius, A. arachidicola, A. minisclerotigenes, A. ochraceoroseus, A. korhogoencis, A. pseudocaelatus, A. pseudotama-
rii, and A. bombycis10. Aflatoxins  B1,  B2,  G1, and  G2 can occur in foods such as groundnuts, tree nuts, maize, 
rice, figs, dried spices, crude vegetable oils, cocoa beans, cocoa powder, chocolate, cotton seeds, copra etc.11,12. 
Aflatoxins  M1 and M 2 are found in milk and milk products. Human hepatic cancer and acute fatal diseases eg. 
Hepatitis have occurred in association with the consumption of heavy contaminated foods in Asia, africa and 
else  where13,14,
Ochratoxins are the main mycotoxin with nephrotoxic effects and have been associated with Balkan Endemic 
Nephropathy and tumour development in the urinary  tract15–17. Ochratoxin A (OTA) is a toxic secondary 
metabolite produced by several species of Aspergillus and Penicillium genera. For example, OTA is produced by 
Aspergillus carbonarius, A. sclerotiorum, A. sulphureus, A. alliaceus, A. affinis, A. albertensis, A. welwitschive, A. 
cretensis, A. alutaceus (= A ochraceus) and A. niger and species belonging to the A. niger a ggregation18,19 in tropical 
 zones18,20–22. The European Food Safety  Authority23 affirmed that OTA is nephrotoxic in all animal species tested 
and exerts immunotoxic, neurotoxic, and teratogenic effects at high dose levels. OTA has been detected in high 
contamination levels in maize, rye, coffee, cocoa powder, and chocolate, and other related foods in A frica24–28. 
Penicillium verrucosum and P. nordicum also grew well and produced  OTA18.
Fumonisin is a group of fifteen (15) closely related mycotoxins produced by species of Fusarium i.e. F. prolif-
eratum, F. globosum, F. nygum, F. subglutinans, F. verticillioides = (F. moniliforme) all included in the Gibberella 
fujikuroi species c omplex29. F. verticillioides is important in veterinary medicine as a cause of porcine pulmonary 
edema and equine leucoencephalomalacia and oesophageal cancer in humans. Several cogenes of fumonisins 
A 1,  A2,  B2, B 293 and B 4 as well as P are k nown . Studies have also shown that some strains of Aspergillus niger, A. 
welwitschiae as well as Alternaria alternata and Fusarium oxysporum also produce fumonisins. Fumonisins have 
been shown to occur in barley, wheat, sorghum, rice, millet and corn p roducts29. The most common syndromes 
associated with fumonisins are leucoencephalomalacia in horses, pulmonary oedema and hydrothorax in pigs, 
and hepatotoxicity, carcinogenicity and oesophageal cancer in h umans9,30.
Zearalenone, ZEA, previously known as F2-toxin in a resorcyclic acid lactone produced by Fusarium gramine-
arum, F. colmorum, F. crookwellense, and F. equiseti31,32. Another mycotoxin of health importance is Vomitoxin 
which is also known as deoxynivalenol (DON) and is a type B trichothecene, an epoxy sesqueterpenoid. It occurs 
predominantly in grains, e.g. wheat, maize, barley, rye, oat, and less so in rice, sorghum and t riticale33. It is a 
secondary metabolite of Fusarium culmorum and F. graminearum.
Patulin is isolated from several species belonging to the genera Aspergillus, Penicillium, Paecilomyces, and 
Byssochlamys. Among the Aspergillus species, the number of patulin producing species is limited to three of the 
Clavali group, namely, A. clavatus, A. giganteus, and A. longivestica34. Within the genus Penicillium, patulin-
producing species are P. carneum, P. glavigeum, P. concentricum, P. coprobium, P. dipodomyicola, P. expansum, P. 
patulum, Psclerotigenum and P. valpinum35. In the case of Paecilomyces and Byssochlamys, B. nivea and B. satu-
ranus produce patulin but B. fulva does  not36,37. Currently, the list of mycotoxins levels in food is regulated in 
many countries including European Community and Africa are aflatoxins, ochratoxin A, zearalenone, fumonisins 
and  trichothecene36.
Food safety is a vital gauge or criterion for enhanced food security. In sub–Saharan Africa where major food 
losses occur, health challenges and even human fatalities have arisen from eating contaminated key staple foods 
by fungal pathogens in the field (field fungi) and in storage (storage fungi)38–40.
The most effective way to prevent mycotoxin formation in stored staple food from the farm gate through the 
food value chain is to implement Good Agricultural Practices (GAP), Good Manufacturing Practices (GMP), 
and Hazard Analysis of the Produce at the Critical Control Point (HACCP) (13,022,000; 2005). Post-harvest 
practices (drying, sorting, removal of broken and mouldy ones, keeping perishable staples in well-ventilated 
storage houses etc.) could also help in reducing food quality losses not excepting preharvest practices such as 
crop rotation, row planting, etc.6,41.
In 2011, The Food and Agriculture Organisation, (FAO) funded a Continental Programme on Post-Harvest 
Losses (PHL) Reduction in Sub-Saharan Africa, including Ghana. The F AO42 PHL report covered staple food 
commodities (processed and unprocessed), e.g. maize, sorghum, millet, cowpea, rice, plantain, cassava, cocoyam, 
yam, fruits (mango, orange, pineapple, tangerine) oil palm, tomatoes, okra, groundnut, bambara groundnut, 
etc. poultry and poultry products, Livestock (cattle, sheep, goats, guinea fowls, fish (marine and artisanal etc.) 
and made recommendations to increase food security along the food value chain in Ghana. FAO made a recom-
mendation for improving food safety and security.
Prior to the F AO42 PHL report, and thereafter there have been over 41 fungal species identified belonging 
to more than 20 genera recorded as field and storage contaminants of staple foods, spice and spice products, 
grains and grain products, pulse and beans in  Ghana43. These fungal contaminants included species of the 
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 2
Vol:.(1234567890)
www.nature.com/scientificreports/
aforementioned mycotoxin-producing genera: Aspergillus, Alternaria, Curvularia, Candida, Fusarium, Monilia, 
Geotrichum, Mucor, Neurospora, Oidiodendron, Paecilomyces, Penicillium, Pullularia, Rhizoctonia, Rhizopus, 
Syncephalastrum, Torula, Trichothecium, Saccharomyces and Trichoderma44–55 etc. Aspergillus species (A. aluta-
ceus = A. ochraceus, A. candidus, A. fumigatus, A. glaucus, A. niger, A. sulphureus, A. terreus, A. amstelodami, A. 
ustus, A. nidulans, A. tamarii, A. flavus) predominated over other species encountered followed by Penicillium (P. 
digitatum, P. expansum, P. verrocusum, P. oxalicum, P. frequentans, P. purpurogenum, P. urticae) Paecilomyces (P. 
puntonii, P. varioti); Rhizopus (R. oligosporus, R. oryzae, R. stolonifer); Fusarium (F. verticillioides = F. moniliforme, 
F. nivale, F. oxysporum), Alternaria alternata, Curvularia lunata, Geotrichum albidium, Neurospora sitophila, etc.56.
When potential mycotoxin-producing species are predisposed to conducive environmental conditions such 
as in the tropics, risk factors triggering mycotoxigenesis are induced into action, especially when farmers and 
the general population are not abreast with the risk factors because of the paucity of information.
The pertinent literature on mycotoxins found in Ghanaian staple foods, spices, cereals, peanuts, and processed 
grain and peanut products is replete with examples of mycotoxin contamination of foods. Table 1 summarizes 
mycotoxins detected in Ghana’s staple foods, food products, spices, and seasoning products. These findings 
underscore the view that there is a paucity of information on the application of techniques to curtail toxin forma-
tion in our foods. The prerequisites for extending the shelf life and quality of agricultural produce are not well 
understood by the populace and farm handlers of stored agricultural produce. To the best of our knowledge, 
there is hardly any published report on the knowledge, handling of stored foods, attitude to the consumption of 
mycotoxin-contaminated foods as well as the pre-and post-harvest handling of food to preclude proliferation 
and in vivo mycotoxin formation in stored agricultural produce in Ghana.
Food products Mycotoxin detected Fungus References
Aflatoxins Aspergillus flavus
Maize grains (whole) 57–59
Ochratoxins Aspergillus carbonarius, Penicillium verucosum
Maize powder Aflatoxins A. flavus 12,60,61
Fumonisins Fusarium verticillioides
Fermented maize 62–64
Aflatoxins A. flavus
Kenkey Aflatoxins A. flavus 60
Ice kenkey Aflatoxins A. flavus 65
Fumonisins Fusarium verticillioides 66
Weanimix cereals
Aflatoxin A. flavus 67
Maize-groundnut mix Aflatoxins A. flavus 68
Dry cassava products Aflatoxins A. flavus 47
Kokonte Aflatoxins A. flavus 47
Sterigmatocystin A. versicolor
Tentazonic acid Alternaria spp.
Cassava flour Cyclopiazonic acid 47
Penicillinic acid Aspergillus spp., Penicillium spp.
Patulin
Cereals Aflatoxins A.flavus 69,70
Peanut/groundnuts Aflatoxins A.flavus 71–74
Raw cow milk Aflatoxin M1 A. flavus 75–77
‘Brukina’ (fermented millet based milk beverage) Aflatoxin M1 A. flavus 78
‘Wagashie’ (traditional soft cottage cheese) Aflatoxin M1 A. flavus 79
Aqueous extract of fruit of pepper, okra, tomato Aflatoxins A. flavus 80
Millet Aflatoxins 81
Seasoning powder spices N.D A. flavus, Penicillium spp 43
Spice and spice products N.D A. flavus, Penicillium spp 45
Kebab spice mix Aflatoxins Miscellaneous including A. flavus 46
Spices and herbs Aflatoxins Miscellaneous including A.flavus and Fusarium sp. 82,83
Fruits and Vegetables Aflatoxins A. flavus 84
Nuts and oils Aflatoxins A. flavus 84
Fumonisins Fusarium sp. 85
Plantains
Ochratoxins Penicillium sp. 85
Aflatoxins A. flavus 86
Cocoa beans
Ochratoxins A. carbonarius 86
Animal feed Aflatoxins A. flavus 84
Table 1.  Some mycotoxins detected in Ghanaian staple foodstuffs, spices, and spice mixtures kept under 
normal tropic ambient conditions.
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 3
Vol.:(0123456789)
www.nature.com/scientificreports/
Methodology
Study design. This study was both qualitative and quantitative research. A prospective cross-sectional study 
design was used to collate information from food vendors and members of the Ghanaian populace and their 
basic knowledge, attitudes, and practices to mitigate infection of fungi in foods using a structured online ques-
tionnaire.
Study site. The study was carried out across the country. Ghana is on the Gulf of Guinea, West Africa, where 
it covers about 23,884,245 ha of land and water and is positioned between latitudes 4°N and 11°N and longitudes 
4° W and 2°E. Sixteen (16) regions and 216 districts constitute the country and are well defined by five broadly 
characterized agro – ecological zones, namely, Coastal Savannah, Evergreen Deciduous Forest, Transitional, and 
Savannah (Fig. 1). The population of Ghana currently stands at 31,000,062 people according to the data of Ghana 
Statistical S ervice87.
Desk study. A desk study was carried out to collate available information (on the internet) in Ghana on the 
occurrence and detection of some principal mycotoxins found in food. This is presented in Table 1. This spans 
the period 1986–2022.
Key—Population of regions.
Figure 1.  Map of Ghana showing the sixteen regions where sampling of views was carried out to assess the 
information required. Source: https:// upload.w ikime dia.o rg/ wikip edia/ commo ns/e/ e7/N EW_G HANA_R EGIO 
NS. jpg.
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 4
Vol:.(1234567890)
www.nature.com/scientificreports/
1 = 653,266 2 = 2479 3 = 4,780,380 4 = 1,208,699
5 = 868,479 6 = 2,633,154 7 = 3,093,000 8 = 2,310,983
9 = 742,664 10 = 711,435 11 = 2,118,252 12 = 2,201,863
13 = 658,903 14 = 1,046,545 15 = 564,536 16 = 5,455,692
Inclusion criteria. Members of the Ghanaian populace who have basic knowledge in food safety.
Exclusion criteria. Members of the Ghanaian populace who do not have basic knowledge in food safety.
Determination of sample size. We adopted the prescribed formula of Yamane (1967) where:
N
n = .
1 + Ne2
In this formula, “n” represents the sample size to be calculated, while “N” is the relevant population. The value 
of “e‟ (standard error) depends on the required confidence level set by the researcher. If the confidence level 
is 0.95 percent, then the “e‟ value would be 0.05. In this study, a 95% confidence level was adopted. Our check 
revealed that the population of Ghana is about 31,000,000 which also represents food consumers in Ghana. There-
fore, for N = 31,000,000, e = 5%, therefore n = 385.10 which approximates to 385. This implies that the minimum 
recommended size (number) is 385 respondents. We exceeded this and recruited 642 respondents nationwide.
Data collection. An online questionnaire was designed for the national survey and divided into 4 sections: 
socio–demographic characteristics; basic knowledge of the respondent on fungal presence in foods; respondent 
practices on the control and management of fungi in foods; respondent in-depth knowledge and management 
of fungi in foods. In the socio–demographic section, respondents were asked to provide information on their 
age, sex, occupation, and residential region. The basic knowledge of respondents on the presence of fungi in food 
allowed respondents to portray their layman’s knowledge about the presence of fungi in foods. The respondent’s 
practice for the control and management of fungi in food gave a clue as to how they handled foods that have 
been contaminated with mycotoxins and how they manage the occurrence of fungi. On the question of attitude 
towards the knowledge and management of fungi in foods, we derived from the respondents their knowledge 
and management of fungi in food. After due consultation with respondents who were 18 years and above, the 
questionnaire was uploaded onto all social media platforms.
The online survey was conducted between April to June 2021. A reminder was sent to all potential respond-
ents in July 2021. All returned responses were checked and verified to ensure proper completion. A total of 642 
validated questionnaires were returned.
Fully completed survey forms. Fully completed surveys were deemed valid responses. English was the main 
language used to communicate in the interview and questionnaire, but where there was the need for a different 
language, help was provided by an interpreter. All our national COVID-19 protocols were strictly adhered to, i.e. 
ensuring the wearing of face masks, the use of sanitizers, washing of hands thoroughly, and socially distancing 
during the survey.
All methods were carried out in accordance with relevant guidelines and regulations.
Ethics approval and consent to participate. Ethical clearance and permission were sought from the 
University of Health and Allied Sciences (UHAS) ethical clearance committee with Protocol Identification Num-
ber: UHAS-REC A.946 20–21. We confirm that informed consent was obtained from all subjects.
Statistical analysis. Completeness and consistency of the data were checked and entered into Statistical 
Package for Social Sciences (IBM SPSS) data analysis software version 20 was employed to analyze the quantita-
tive data obtained from the respondents. IBM SPSS was used to detect and remove inaccurate and incomplete 
data. Results were presented as descriptive statistics in tables, and graphs to facilitate interpretation. A threshold 
of significance was set at < 0.05 (p < 0.05).
The Chi-Square test of association was carried out to determine whether there was a significant association 
between categorical variables. The Mann–Whitney test was also used to test differences between two groups, 
while the Kruskal–Wallis test was used to test differences between more than two groups. The Conover-Iman 
pairwise comparison test was carried out on the categories within the variables.The statistical Hosmer–Lemeshow 
test, correct classification rate (CCR), and Area under the curve (AUC) were considered as the parameters for the 
goodness of fit test for the model. The Hosmer–Lemeshow test measured how poorly a model predicts an event 
of interest. Another useful measure to assess the utility of a logistic regression model is the correct classification 
rate (CCR). The area under the curve (AUC) is a measure of the ability of a classifier to distinguish between 
classes and is used as a summary of the ROC curve. Finally, Wilcoxon paired sample comparison test was used 
to test the familiarity of the respondents with yeasts and molds as well as mycotoxins likely to be found in the 
foods. Microsoft Excel version 2013 was used to plot the graphs.
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 5
Vol.:(0123456789)
www.nature.com/scientificreports/
Results
The results of the desk study on the incidence and detection of mycotoxins in foods in Ghana are summarized 
in Table 1. The products include staple foods, dehydrated and processed products, etc. Mycotoxins detected 
were aflatoxins, fumonisins, sterigmatocystin, tenuazonic acid, patulin, and penicillanic acid (Table 1). Fungal 
genera producing these toxins were predominantly in the genus Aspergillus, Penicillium, and Fusarium (Table 1).
Demographic data. The demographical data is summarized in Table 2. The majority of the respondents 
were between the ages of 18–25 years (46.6%); older people of 45 years and above formed the minority (1.9%). 
The respondents were predominated by males (52.3%) and by females (47.7%). The married constituted 69.3% 
and the remaining 30.7% were single. The majority of the respondents (80.4%) were either studying in tertiary 
education or had completed it, and only 3.0% had informal education. Interestingly, 44.5% of the total respond-
ents have had a formal education; 52.5% were students and 3% were in informal education.
There was an inequitable return of questionnaires from the various regions. Most respondents resided in 
the Volta Region (24.8%) followed by Greater Accra (21.2%) and Eastern Region (10.0%) followed by Ashanti 
Region (9.8%). The remaining regions recorded less than 10% response with the least coming from North East 
(0.8%) and Western North (0.8%).
Knowledge of the types of mycotoxins in foods. Respondents indicated their knowledge of the 
mycotoxins likely to occur in Ghanaian foods. There were multiple responses and a summary of the results is 
shown in Table 3. The majority of the respondents selected aflatoxins 453/843 (55.7%) followed by ochratoxin 
137/843 (16.3%) and fumonisins 136/843 (16.1%). Zearalenone 54/843 (6.4%) was less known to the respond-
ents. The remaining mycotoxins (patulin, trichothecene, ergot alkaloids, vomitoxin (deoxynivalenol)) scored 
01–0.6% (Table 3). Interestingly, 0.4% and 0.1% of the respondents believed that yeasts and bacteria, respectively, 
also produce mycotoxins. Finally, 5.7% had no idea about mycotoxins in foods (Table 3).
Variables Categories Freq %
18–25 304 47.3%
26–35 231 36.0%
Age
36–45 95 14.8%
Above 45 12 1.9%
Female 306 47.7%
Gender
Male 336 52.3%
Basic education 3 0.5%
Post-graduate education 92 14.3%
Educational level
Secondary education 31 4.8%
Tertiary education 516 80.4%
Married 197 30.7%
Marital status
Single 445 69.3%
Formal 286 44.5%
Occupation Informal 19 3.0%
student 337 52.5%
Ahafo region 7 1.1%
Ashanti region 63 9.8%
Bono east region 7 1.1%
Bono region 14 2.2%
Central region 32 5.0%
Eastern region 64 10.0%
Greater Accra 136 21.2%
North east 5 0.8%
Region of respondent
Northern region 47 7.3%
Oti region 8 1.2%
Savannah region 12 1.9%
Upper east region 26 4.0%
Upper west region 30 4.7%
Volta region 159 24.8%
Western north region 5 0.8%
Western region 27 4.2%
Table 2.  Demographic characteristics of respondents.
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 6
Vol:.(1234567890)
www.nature.com/scientificreports/
Mycotoxins N % % of cases
Aflatoxins 453 53.7% 70.7%
Ochratoxin 137 16.3% 21.4%
Fumonisin 136 16.1% 21.2%
Zearalenone 54 6.4% 8.4%
Patulin 5 0.6% 0.8%
Neurotoxin 2 0.2% 0.3%
Trichothecenes 2 0.2% 0.3%
Ergot alkaloids 1 0.1% 0.2%
Vomitoxin (DON) 1 0.1% 0.2%
Yeast 3 0.4% 0.5%
Bacteria and fungi 1 0.1% 0.2%
Don’t know 48 5.7% 7.5%
Total 843 100% 131.5%
Table 3.  Multiple response analysis on the knowledge about types of mycotoxins in Ghana.
Food commodity N % % of cases
Bread 43 2.1% 6.7%
Cereals 294 14.5% 45.9%
Meat 260 12.8% 40.6%
Root and tubers 296 14.6% 46.2%
Peanuts and other nuts 216 10.7% 33.8%
Vegetables 310 15.3% 48.4%
Fruits 343 16.9% 53.6%
Fish 257 12.7% 40.2%
Kenkey 7 0.3% 1.1%
Total 2026 100% 316.6%
Table 4.  Multiple response analysis by panelists on food commodities or processed food susceptibility to 
fungal and yeasts contamination.
Identification of food commodities predisposed to infection by moulds and yeasts. Moulds 
and yeasts are ubiquitous and can be resident preferentially in any nutrient-rich substrate for their  growth88. In 
this survey, respondents identified fruits, vegetables, and fish (12.7–16.9%) as the most susceptible to infection; 
cereals, meat, root, and tuber crops also experienced mouldiness (12.8–14.6%) while bread was mentioned by 
only 2.1% of the respondents (Table 4). Peanuts (groundnuts) and other nuts were also prone to contamination 
(10.7%). Interestingly, respondents found kenkey less susceptible (0.3%), contrary to the general view of the 
populace.
Categories N % % of cases
Bread 394 35.3% 61.8%
cereals 88 7.9% 13.8%
fruits 106 9.5% 16.6%
vegetables 100 9.0% 15.7%
Meat 106 9.5% 16.6%
Pea nuts and other nuts 48 4.3% 7.5%
None of the foods 145 13.0% 22.7%
Kenkey 12 1.1% 1.9%
Fish 111 9.9% 17.4%
Tubers 2 0.2% 0.3%
Banku 3 0.3% 0.5%
Total 1115 100% 174.9%
Table 5.  Multiple response analysis by the respondents of foods consumed in spite of visible fungi growth on 
the commodity.
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 7
Vol.:(0123456789)
www.nature.com/scientificreports/
Multiple analysis of the response of respondents to the consumption of food despite identifi‑
cation of visible fungal growth. Table 5 summarises the results obtained from the survey using the ques-
tionnaire. Bread was the most consumed commodity (35.5%) despite visible signs of fungal contamination. This 
was followed by fish (9.9%), fruits (9.5%), meat (9.5%), and vegetables (9.0%). Only 0.2–0.3% of respondents ate 
infected root tubers and banku. Curiously, about 1.1% of the respondents avoided eating contaminated kenkey 
and 13.0% did not eat any of the listed foods found infected with fungi (Table 5).
The respondents from the regions adduced several reasons for attempting to eat food visibly infected with 
fungi as shown in Table 5. For example, 55.6% of the respondents consumed food visibly infected with fungi. 
Some respondents (15.5%) also ate food with visible fungal contamination because they believed nothing fatal 
happened to them after eating and a further 3.8% of respondents purchased such contaminated food because 
they were cheaper on the market (Table 6). A greater percentage (6.5%) did not find any change in taste after the 
contaminated food was cooked for eating.
Knowledge of the adverse health effects on humans who consume contaminated foods intox‑
icated with mycotoxins. Table 7 is a summary of the results obtained. About one-third (32.9%) of the 
respondents believe that consumption of mycotoxin-contaminated foods can cause stomach upsets and aching. 
On the other hand, 30.8% attributed the incidence of diarrhea after toxin intoxication to the ingestion of con-
taminated food. Still others (15.5%) indicated that immunosuppression can be attributed to mycotoxins, while 
Categories N % % of cases
Shortage of food 74 10.7% 15.0%
Scrape off, wash or cut infected portion 383 55.6% 77.5%
Nothing happened after eating 107 15.5% 21.7%
The taste of the food does not change on cooking 44 6.4% 8.9%
Do not believe they are harmful toxins 55 8.0% 11.1%
Contaminated foods are cheaper on the market 26 3.8% 5.3%
Total 689 100% 139.5%
Table 6.  Multiple response analysis by respondent’s attitude towards consuming foods showing visible fungal 
growth.
Type of ailment N cumulative response % % of cases
Stomach ache 502 32.9% 78.7%
Cancer 137 9.0% 21.5%
Immuno-suppression 236 15.5% 37.0%
Diarrhea 470 30.8% 73.7%
Fever 179 11.7% 28.1%
Total 1524 100% 238.9%
Table 7.  Multiple response analysis on knowledge of the adverse effects of mycotoxins on consumers.
Questions on knowledge and answers application of management practice Freq N %
Always 55 8.6%
Frequently 190 29.5%
Do you hear often about fungi, yeast, or mold growth and its harmful effects? Never 38 5.9%
No idea 34 5.3%
Seldom 326 50.7%
No 25 3.9%
Can fungal growth in foods be prevented or controlled?
Yes 618 96.1%
Discarding foods with visible fungal growth 81 12.6%
Ensuring clean environment 18 2.8%
How can fungi in foods be controlled or prevented?
Proper storage of foods 501 77.9%
Use of fresh food commodities in cooking 43 6.7%
Table 8.  Knowledge and application of storage management practices.
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 8
Vol:.(1234567890)
www.nature.com/scientificreports/
Variables Mean SD Freq % P-value
Gender
 Female 4.376 0.898 306 47.7
0.3678
 Male 4.452 0.948 336 52.3
Age
 Below 18 3.800a 0.447 5 0.8
 18–25 4.321a 0.903 299 46.6
 26–35 4.498a,b 0.913 231 36 0.039*
 36–45 4.526b 0.988 95 14.8
 Above 45 4.583a,b 1.084 12 1.9
Educational level
 Basic education 4.667b 0.577 3 0.5
 Secondary education 3.839a 0.898 31 4.8
0.008*
 Tertiary education 4.442b 0.911 516 80.4
 Post-graduate education 4.457b 0.965 92 14.3
Marital status
 Married 4.447 0.922 197 30.7
0.2819
 Single 4.402 0.926 445 69.3
Occupation
 Formal 4.458 0.972 286 44.5
 Informal 4.368 0.831 19 3.0 0.858
 Student 4.383 0.889 337 52.5
Region
 Ahafo region 4.571 0.787 7 1.1
 Ashanti region 4.460 0.820 63 9.8
 Bono east region 4.571 0.535 7 1.1
 Bono region 4.143 0.663 14 2.2
 Central region 4.500 1.016 32 5.0
 Eastern region 4.547 0.942 64 10.0
 Greater Accra 4.279 0.875 136 21.2
 North east 4.600 0.548 5 0.8
0.777
 Northern region 4.426 0.972 47 7.3
 Oti region 4.250 1.035 8 1.2
 Savannah region 4.250 1.215 12 1.9
 Upper east region 4.846 1.223 26 4.9
 Upper west region 4.367 0.928 30 4.7
 Volta region 4.415 0.923 159 24.8
 Western north region 4.200 0.837 5 0.8
 Western region 4.407 0.971 27 4.2
Table 9.  Differences in knowledge among demographic groups. Kruskal Wallis test was used to whether 
significant differences existed between groups. Significant differences existed between the categories under age 
and educational level. The Conover-Iman pairwise comparison test was carried out on the categories within 
the variables. Significant values are in bold. Means with same superscript letters are not significantly different 
(p>0.05). Means with superscript asterisk (*) are significantly different (p<0.05).
some 11.7% indicated that toxins can cause fever. The remaining 9.0% had indicated that mycotoxins can be 
carcinogenic in their effect on humans and animals alike.
Knowledge and application of practices for the control and management of fungal contamina‑
tion in stored foods. Although half of the respondents (50.7%) had seldom heard about fungi and their 
growth in foods, 34–38% either never heard about it and 5.3% had no clue about it (Table 8). Curiously, 77.9% of 
the respondents follow the traditionally prescribed storage conditions to preserve food. About 6.7–12.6% either 
discard visibly contaminated food or use only fresh food for cooking and consumption purposes (Table 8).
Statistical relatedness of data obtained from the survey. Tables 2, 3, 4, 5, 6, 7, 9, 10, 11, 12 and 13 
summarize the rest of the statistical analysis of the data obtained from the questionnaire.
Results in Table 8 show that age was directly related to knowledge about the occurrence of fungi and myco-
toxins in foods (p < 0.05); educational level also was positively related to knowledge about the occurrence of 
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 9
Vol.:(0123456789)
www.nature.com/scientificreports/
Source P-value OR OR L (95%) OR U (95%)
Intercept 0.519
Age group
 18–25
 26–35 0.032 2.526 1.083 5.890
 36–45 0.020 4.194 1.256 14.007
 Above 45 0.026 4.444 0.539 36.620
 Below 18 0.001 0.999 0.103 9.733
Gender
 Female
 Male 0.620 0.878 0.524 1.470
Educational level
 Basic education
 Post-graduate education 0.817 0.635 0.014 29.614
 Secondary education 0.418 0.214 0.005 8.984
 Tertiary education 0.976 0.945 0.022 41.233
Marital status
 Married
 Single 0.112 1.952 0.856 4.453
Occupation
 Formal
 Informal 0.723 1.307 0.299 5.718
 Student 0.023 2.172 1.110 4.249
Region
 Ahafo region
 Ashanti region 0.836 0.710 0.028 18.029
 Bono east region 0.794 0.562 0.007 43.034
 Bono region 0.445 0.263 0.009 8.072
 Central region 0.962 1.089 0.033 36.504
 Eastern region 0.758 0.602 0.024 15.279
 Greater Accra 0.684 0.517 0.022 12.337
 North east 0.845 0.643 0.008 53.595
 Northern region 0.583 0.404 0.016 10.289
 Oti region 0.410 0.226 0.007 7.737
 Savannah region 0.713 0.510 0.014 18.573
 Upper east region 0.602 0.413 0.015 11.510
 Upper west region 0.492 0.317 0.012 8.426
 Volta region 0.615 0.443 0.019 10.569
 Western north region 0.409 0.206 0.005 8.805
 Western region 0.837 0.701 0.024 20.547
Goodness fit test
 Hosmer–Lemeshow test P-value = 0.767
 CCR (%) 90.03%
 AUC 66.60%
Table 10.  Hosmer–Lemeshow test measuring the odds of basic knowledge of fungi presence in different age 
groups. OR odds ratio, ORL odds ratio lower boundary, ORU odds ratio upper boundary.
Average KAP score (out of a possible 7) Average KAP score (out of a possible 100)
4.42 ± 0.92 63.08 ± 13.21%
Table 11.  Average knowledge, attitude and practice (KAP) score obtained from respondents.
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 10
Vol:.(1234567890)
www.nature.com/scientificreports/
Familiarity with molds, yeasts, and mycotoxins using Wilcoxon paired sample comparison test
Responses % (n)
Statements 1* 2* 3* Mean SD P-value
How familiar are you with these terms; molds and yeasts 2.8 (18) 51.2 (329) 46.0 (295) 2.431 0.549
 < 0.0001*
How familiar are you with the term ‘Mycotoxins’ 24.8 (159) 49.1 (315) 26.2 (168) 2.014 0.714
Overall mean score (n = 632) 2.223 0.554
Table 12.  Respondents familiarity with the terms mold, yeasts, and mycotoxins. 1* no idea, 2* quite familiar, 
3* very familiar. Significant values are in bold.
Knowledge score category
Variable Score < 50% Score ≥ 50% Total % P-value
No 35 327 56.4
Do you consume food showing visible fungi growth? Sometimes 20 211 36.0 0.013*
Yes 11 38 7.6
No 17 104 18.8
Do you check for the presence of molds and fungi on foods before consumption? 0.13
Yes 49 472 81.2
Table 13.  Respondent practices for the control and management of fungi in food. Scores < 50% indicate 
inadequate knowledge and Scores ≥ 50% indicate adequate knowledge. *Significant at 5%. Significant values are 
in bold.
fungi and mycotoxins in foods (p < 0.05). All other demographic characteristics investigated (marital status, 
occupation, regional affiliation) were found to have no significant (p > 0.05) influence on the knowledge status 
of the respondents.
From Table 9, the same alphabet superscript assigned to categories denotes insignificant differences between 
groups. Different alphabets denote significant differences between groups.
Knowledge among age groups below 18 and 18–25 is significantly different from the age group 36–45.
Knowledge among those with secondary education is significantly different from those with basic, tertiary, 
and postgraduate education.
The Hosmer–Lemeshow test which is a statistical test for the logistic regression model is used frequently as 
a risk prediction model. Results showed that the model is a good fit (P-Value > 0.767). The CCR of 90.03% and 
the AUC of 66.60% also confirm that the model is a good fit ( Table 10).
With knowledge status as the dependent variable, the independent variables in the model were statistically 
insignificant except for the age group variable. Age groups above 45 years have increased odds of basic knowledge 
of fungi presence than the age group 36–45. Age groups 36–45 also have increased odds of basic knowledge of 
fungi presence than the age group 25–35. Age groups 25–35 also have increased odds of basic knowledge of fungi 
presence than the age group below 18 years. The age group 18–25 was used as the reference group.
In the  Table 11, the average KAP score for knowledge indicated that, out of a total of 100%, there was adequate 
knowledge (63.8%) among the members of the Ghanaian populace. As to how familiar the respondents were 
with the terms mold and yeast, a mean score of 2.431 was obtained; how familiar the respondents were with 
the term mycotoxin recorded a mean score of 2.014 which is lower than the average mean of the knowledge of 
respondents. The results show that the familiarity of the respondents with the terms; molds, yeast, and mycotox-
ins were directly related to their knowledge about the occurrence of mycotoxins in foods (p < 0.05) (Table 12).
The Chi-square test of association was conducted to ascertain whether a statistical relationship existed 
between the practices for the control and management of fungi in food and their knowledge of the occurrence 
of fungi in foods. In terms of the practice of management and control of fungi in foods, respondents who did 
not consume food showing visible fungi growth constituted 56.4%; respondents who consumed food with visible 
fungi growth constituted with them was 36.0%. Results in Table 13 show that the consumption of food showing 
visible fungal growth is significantly (p < 0.05) related to the knowledge about the occurrence of fungi in foods. 
Respondents who inspected food for the presence of fungi on foods before consumption was 81.2%, while 
respondents who did not check for the presence of molds and fungi on foods before consumption constituted 
18.8%. The results showed that it is not related to the knowledge of the occurrence of fungi in foods (p > 0.05).
Discussion
Mycotoxin contamination of foods and processed food products is a universal problem that denies the grains 
from crop harvest the full benefits for use in food security. No country is exempt from fungal intoxication in 
food. The results of the desktop study showed a whole array of foodstuffs contaminated by potent mycotoxins of 
health importance and belonging to the genera Aspergillus, Penicillium, and Fusarium (Table 1). Local research 
into the occurrence of mycotoxins in Ghana is encouraging but a lot more needs to be done particularly in the 
area of damage to human health and its long-term effects on longevity. The pertinent literature in West Africa 
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 11
Vol.:(0123456789)
www.nature.com/scientificreports/
is replete with studies on the incidence of mycotoxins in staple edible foods and spices. Mycotoxins detected 
include aflatoxins, fumonisins, ochratoxins, penicillinic acid, patulin, vomitoxin (deoxynivalenol), zearalenone, 
 trichothecenes28,38,89–96. The same is true for East and Central A frica6,38,97–100. Extensive studies on mycotoxins in 
staples, edible foods, and spices have also been carried out in Southern A frica101 and E gypt102,103. What needs to 
be underscored, is the education of the population to identify conditions of storage that predispose stored foods 
to mycotoxin contamination and the need to avoid the use of mouldy foods for animal and human consumption.
Results from the current study show that the majority of the respondents in the study were between the 
youthful ages of 18–25 yrs and had adequate knowledge about the contamination of foods by fungi. This agrees 
with the findings o f104 who found the knowledge of natural toxins in foods by students of ages between 21 and 
25 yrs in tertiary institutions in Ghana. This trend could be attributed to the larger volume of information on 
the internet available to the computer-literate youth on their mobile phones, laptops, and other gadgets. Another 
source of information on food intoxication could come from occasional educative FM radio, TV programs, and 
videos that they could access from their phones out of curiosity.
Our present result contrasts the findings  of97 in Kenya. They showed that respondents above 35yrs were more 
knowledgeable about fungi and natural mycotoxin contamination because of their field experience of more than 
20yrs as farmers. Cultural influences may therefore determine the acquisition of the intuition to identify and 
deal with natural mycotoxin contamination in stored foods.
There was a preponderance of male over female respondents in this present study. Presumably, women carry 
out duties related to food processing and cooking in addition to other ancillary activities at home and so makes 
them relatively busy. Indeed, Jere et al.105 reported that in Malawi, women generally carry out food processing and 
cooking activities in addition to other household chores which keep them occupied for the best part of the day. 
Jere et al.105 carried out studies related to the exposure of school children to aflatoxins (from Aspergillus flavus) 
and fumonisins (Fusarium species) in Malawi and confirmed the detection of high concentrations of mycotoxins 
in food prepared by women in addition to their other household chores. The same was true in T anzania106 and 
N igeria107. They surmised that educational level plays a major role in the detection and corrective interventions 
in mycotoxicosis as earlier endorsed b y108.
Our current study showed that in Ghana, female respondents were significantly (p < 0.05) less knowledgeable 
than their male counterparts (data not shown), while Matumba et al.6 stated that women played a significant 
role in the hawking, preparation, and utilization of foods in Malawi. In other instances in Tanzania, Magembe 
et al.97 found that female respondents showed greater and adequate awareness of mould infection than men. 
Presumably, both cultural and educational differences in Africa can influence the detection of fungi, natural 
mycotoxin contamination, and response to practical control of storage diseases of fungal origin by their ability 
to identify and infer their presence in foods. In this present study, the majority of our respondents have attained 
tertiary education and had adequate knowledge about the presence of fungi in food while the rest had either no 
education background or are semi-literates with a low level of formal education. Lesuuda et al.109 also reported 
that in Kenya, the majority of their respondents were primary school leavers, and their knowledge of mycotoxin 
contamination of staple food and dehydrated cereal grains was significantly low (p < 0.05).
The statistical analysis managed the inequitable return of questionnaires from the regions since data for the 
entire country was bulked to exceed the minimum number of respondents required for significance. The major-
ity of the respondents were familiar with the terms mould and yeasts and mycotoxins, although the majority 
attributed ingestion of mycotoxins to stomach ache and diarrhea while about 9% attributed mycotoxins as the 
agent of cancer and 15% believed mycotoxins cause immune suppressions (Table 7). Curiously, 30.8% attributed 
mycotoxin ingestion to diarrhea (Table 7). Clearly, their ignorance can be traced to their low level of educa-
tion as reported b y97 in Tanzania. Azaman et al.110 investigated stakeholders’ knowledge, attitude, and practices 
(KAP) towards aflatoxin contamination in peanut–based products and concluded that knowledge influences 
awareness as well as attitudes and conservation and management behavior of farmers. The adequate KAP score 
of 63.08 + 13.21% (Table 11) obtained in this present study agrees with the conclusion  of110.
It is well known worldwide that aflatoxins, especially aflatoxin B1, is the most toxic mycotoxin with severe 
debilitating effects on humans and animals  alike12,111,112. The majority of the respondents in this study (55.7%) 
(Table 3) mentioned aflatoxins as the major mycotoxin they were aware of followed by ochratoxin (16.3%) and 
fumonisins (16.1%); the remaining mycotoxins were less known (0.1–6.4%); while 5.79% had no idea about 
mycotoxins in foods. T oma113 and Matumba et al.6 also found from their studies in Ethiopia and Tanzania 
respectively, that aflatoxins are the best well-known mycotoxins. Studies in Kenya by Lesuuda et al.109 agree with 
our findings that the majority of their respondents knew very little about other mycotoxins other than aflatoxins. 
The pertinent literature contains information on the association between inadequate knowledge about aflatoxin 
contamination with high rates of exposure to a flatoxins100,108,114,115.
Fungal spores are ubiquitous and can settle on any kind of food substrate rich enough to support their growth 
and proliferation provided there are conducive environmental and physical conditions. Naturally, some staple 
foods, cereals and grains, fruits and vegetables, etc. provide a miscellany of nutrients and some better substrates 
for fungal growth than o thers88.
Respondents in this paper identified foods consumed in spite of visible fungal growth (Table 5). Fruits con-
taminated with fungi are discarded when completely infected. However, in many instances, mangoes, oranges and 
guavas etc. are trimmed to remove infected portions and then eaten. Unfortunately, the presence of the fungus 
imparts some toxic metabolites, and mycotoxins associated with fruits are mostly patulin, aflatoxin, ochratoxin, 
fusarial toxins, and Alternaria  toxins6. Cereals and legumes are often infected by mycotoxins such as aflatoxins 
and fumonisins. Interestingly, respondents (35.5%), named bread as the most consumed food even with visible 
fungi and the least (0.2–0.3%) root tubers and banku (made from fermented maize flour). Respondents also 
scored 1.1% for kenkey (another fermented maize product) which is a popular meal in Ghana. The fermented 
dough for the preparation of kenkey made from maize grains is first soaked in water for 2–3 days, after which 
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 12
Vol:.(1234567890)
www.nature.com/scientificreports/
the floating damaged and infected grains are removed by decanting from the surface of the water. This process 
is followed by blending the soaked grains in a disc attrition device corn miller, and the resulting dumpling is 
fermented for 2–3 days before using the dumpling to prepare kenkey. It is known that the clearing and fermen-
tation stages reduce the risk of mycotoxin contamination. It is not surprising that only 1.1% of the respondents 
indicated that maize is consumed even if visibly mouldy. Indeed, there has been only one record of aflatoxin 
contamination of kenkey in G hana60 but the infection of grains and cereals and legumes in storage in silos and 
home barns is well documented by many workers in  Ghana7,44,58,59,64,70–73,84.
Respondents to our structured questionnaires were aware of the health problems associated with the con-
sumption of food contaminated with fungal toxins and named ailments such as stomach ache, diarrhea, sup-
pression of the immune system, cancer, etc. (Table 7). This finding is at variance with the report of Matumba 
et al.6 in Malawi where consumption of mouldy foods was attributed to malaria and high fever. Lack of adequate 
information and minimal educational background could be the cause of such ignorance. Furthermore, the 
problem is accentuated by some health professionals and agricultural extension officers knowing little or not 
having heard about the debilitating effect of continuous ingestion of foods laden with fungal contaminants in 
G hana116,117. On the contrary, Llesanmi and  Llesanmi118 reported that in Nigeria, health workers were abreast 
with the knowledge of infection of foods by mycotoxins produced by fungi and the health risks associated with it. 
However, the prescribed method of removing of mouldy grains from farm produce is not as strictly adhered to. 
Jolly et al.108 stated that although farmers in some African countries are aware of the detrimental consequences of 
eating contaminated foods, their origin, and remedial traditional practices, this has not been strictly adhered to 
in practical terms. It is obvious that public education is lacking in Ghana on the occurrence of aero-mycoflora in 
storage facilities and in the fresh before harvest and the subsequent formation of metabolites in foods for human 
consumption. Cutting-edge technological methods are available for precluding fungi in storage and during food 
processing. Emphasis should be on adapting and applying good storage management practices and changing the 
behavioral lassitude to protect oneself from ingesting mycotoxin-contaminated foods. Unfortunately, the mould 
contaminated cereals, legumes, fruits, vegetables, etc. have been used inadvertently for animal and human feed, 
especially for chickens, ruminants, and o thers119,120. This is subsequently passed on in the meat produced and is 
unintentionally ingested with the toxin.
Kortei et al.121 reported that in Ghana cereals (e.g. Sorghum) with visible mouldiness have been used to pre-
pare local alcoholic beverages with impunity leading to the consumption of mycotoxins (aflatoxins, fumonisins, 
ochratoxins, penicillinic acid, etc.). This viewpoint is endorsed by the data in Tables 4, 7, 11 and 12 showing the 
paucity of relevant information to the public on the potential hazards of mycotoxicosis.
Essentially, a “School Feeding Programme” from UNESCO (Millenium Development Goals) (UNESCO, 2000) 
has been introduced in some African countries to keep children at school and improve their erudition through 
nourishment. The formulation of food and times of the day the pupils are fed vary from country to country. 
Food analysis of the raw materials and food served to the children indicated the intake of mycotoxins (aflatoxins, 
ochratoxins, fumonisin, zearalenone, vomitoxin (deoxynivalenol) etc.) are beyond permissive l evels6,97,100,105,109.
The Government of Ghana has adopted the 2nd Millenium Development Goals of the United Nations, seek-
ing to promote education in all countries through many interventions including the introduction of Nutrition 
and School Feeding Programmes, Ghana School Feeding Programme (GSFP) began in 2 005122. The aim is to 
achieve food security by providing public primary school students with one hot meal per day, usually procured 
from the farm produce of local farmers. It is one of the strategies for achieving the Millenium Development 
Goal 2 (MDGs) on hunger, poverty and primary e ducation123,124. The GSFP is an indicator of the Comprehen-
sive Africa Agricultural Development Programme CAADP Pillar 3, which seeks to enhance food security and 
reduce hunger in line with the UN Sustainable Development Goals (MDGs) on hunger, poverty, and malnutri-
tion (Schoolfeeding.gov.gh).
Granted, the food ingredients used come from buffer stocks and farmer supply. There is a need to screen the 
raw materials for the presence of mycotoxins owing to the fact that we might be feeding our future leaders with 
foods containing mycotoxins with the potential of having a debilitating effect on the health of the youth. The 
urgency of disseminating information on the potential danger and how to handle it in foods and feeds should 
be rigorously  addressed125 in the near future by our scientific food storage and management experts.
Conclusion
In summary, there was adequate knowledge (63.8%) among the members of the Ghanaian populace regarding the 
knowledge and attitude of the occurrence of fungi and mycotoxins in foods as well as during storage. However, 
the respondents’ familiarity with the terms mold and yeasts (fungi) and the different types of mycotoxins was low. 
This undeniably calls for the intensification of education of the Ghanaian populace on yeasts and molds as well as 
mycotoxins in relation to their potential to cause grave harm to humans and animals as they occur in our foods.
Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author upon 
a reasonable request.
Received: 24 August 2022; Accepted: 16 May 2023
References
 1. Walker, S., Jaime, R., Kagot, V. & Probst, C. Comparative effects of hermetic and traditional storage devices on maize grain: 
Mycotoxin development, insect infestation and grain quality. J. Stored Prod. Res. 77, 34–44 (2018).
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 13
Vol.:(0123456789)
www.nature.com/scientificreports/
 2. Green, T. A., Schroeter, B. & Sancho, L. G. Plant Life in Antarctica 13. Funct. Plant Ecol. https:// doi. org/ 10. 1201/ 97814 20007 
626- 139 (2007).
 3. Bbosa, G. S. et al. Review of the biological and health effects of aflatoxins on body organs and body systems. Aflatoxins Rec. Adv. 
Fut. Prospects 12, 239–265 (2013).
 4. Fung, F. & Clark, R. F. Health effects of mycotoxins: A toxicological overview. J. Toxicol. Clin. Toxicol. 42, 217–234 (2004).
 5. Adaku Chilaka, C. & Mally, A. Mycotoxin occurrence, exposure and health implications in infants and young children in Sub-
Saharan Africa: A review. Foods 9, 1585 (2020).
 6. Matumba, L. et al. Uncommon occurrence ratios of aflatoxin B 1, B 2, G 1, and G 2 in maize and groundnuts from Malawi. 
Mycotoxin Res. 31, 57–62 (2015).
 7. Bediako, K. A. et al. Aflatoxin contamination of groundnut (Arachis hypogaea L.): Predisposing factors and management inter-
ventions. Food Control 98, 61–67 (2019).
 8. Atanda, O., Ogunrinu, M. & Olorunfemi, F. A neutral red desiccated coconut agar for rapid detection of aflatoxigenic fungi and 
visual determination of aflatoxins. World Mycotoxin J. 4, 147–155 (2011).
 9. Elkenany, R. & Awad, A. Types of mycotoxins and different approaches used for their detection in foodstuffs. Mansoura Vet. 
Med. J. 22, 25–32 (2021).
 10. Norlia, M. et al. Aspergillus section Flavi and aflatoxins: Occurrence, detection, and identification in raw peanuts and peanut-
based products along the supply chain. Front. Microbiol. 10, 2602 (2019).
 11. Joint, F., Additives, W. E. C. F. & Organization, W. H. Evaluation of certain food additives and contaminants: forty-ninth report 
of the Joint FAO/WHO Expert Committee on Food Additives (World Health Organization, 1999).
 12. Odamtten, G.T. Natural occurrence, economic impact and control of Aflatoxins in Africa. In: WHO Expert Committee Meeting 
on Aflatoxins and Health. Brazaville, Republic of Congo (2005).
 13. Ostry, V., Malir, F., Toman, J. & Grosse, Y. Mycotoxins as human carcinogens—The IARC Monographs classification. Mycotoxin 
Res. 33, 65–73 (2017).
 14. Organization, W. H. & Cancer, I. A. f. R. o. Some naturally occurring substances: food items and constituents, heterocyclic aro-
matic amines and mycotoxins. IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans 56 (1993).
 15. Reddy, L. & Bhoola, K. Ochratoxins—Food contaminants: Impact on human health. Toxins 2, 771–779 (2010).
 16. Pfohl-Leszkowicz, A. & Manderville, R. A. Ochratoxin A: An overview on toxicity and carcinogenicity in animals and humans. 
Mol. Nutr. Food Res. 51, 61–99 (2007).
 17. Abouzied, M. et al. Ochratoxin A concentrations in food and feed from a region with Balkan Endemic Nephropathy. Food Addit. 
Contam. 19, 755–764 (2002).
 18. Wang, Y. et al. Ochratoxin A producing fungi, biosynthetic pathway and regulatory mechanisms. Toxins 8, 83 (2016).
 19. Ayoub, F., Reverberi, M., Ricelli, A., d’Onghia, A. M. & Yaseen, T. Early detection of Aspergillus carbonarius and A. niger on 
table grapes: A tool for quality improvement. Food Addit. Contam. 27, 1285–1293 (2010).
 20. Abrunhosa, L., Paterson, R., Kozakiewicz, Z., Lima, N. & Venâncio, A. Mycotoxin production from fungi isolated from grapes. 
Lett. Appl. Microbiol. 32, 240–242 (2001).
 21. Pitt, J., Basilico, J., Abarca, M. & Lopez, C. Mycotoxins and toxigenic fungi. Med. Mycol. 38, 41–46 (2000).
 22. O’Callaghan, J., Caddick, M. & Dobson, A. A polyketide synthase gene required for ochratoxin A biosynthesis in Aspergillus 
ochraceus. Microbiology 149, 3485–3491 (2003).
 23. EFS Authority. Opinion of the scientific panel on contaminants in the food chain [CONTAM] related to ochratoxin A in food. 
EFSA J. 4, 365 (2006).
 24. Kumagai, S. et al. Aflatoxin and ochratoxin A contamination of retail foods and intake of these mycotoxins in Japan. Food Addit. 
Contam. 25, 1101–1106 (2008).
 25. Brera, C. et al. Ochratoxin A in cocoa and chocolate products from the Italian market: Occurrence and exposure assessment. 
Food Control 22, 1663–1667 (2011).
 26. Sánchez-Hervás, M., Gil, J., Bisbal, F., Ramón, D. & Martínez-Culebras, P. Mycobiota and mycotoxin producing fungi from 
cocoa beans. Int. J. Food Microbiol. 125, 336–340 (2008).
 27. Mounjouenpou, P. et al. Filamentous fungi producing ochratoxin a during cocoa processing in Cameroon. Int. J. Food Microbiol. 
121, 234–241 (2008).
 28. Copetti, M. V., Iamanaka, B. T., Pitt, J. I. & Taniwaki, M. H. Fungi and mycotoxins in cocoa: From farm to chocolate. Int. J. Food 
Microbiol. 178, 13–20 (2014).
 29. Altomare, C., Logrieco, A. F. & Gallo, A. Mycotoxins and mycotoxigenic fungi: Risk and management. A challenge for future 
global food safety and security (2021).
 30. Smith, G. W. Fumonisins. In Veterinary Toxicology (ed. Smith, G. W.) 1003–1018 (Elsevier, 2018).
 31. Ferrigo, D., Raiola, A. & Causin, R. Fusarium toxins in cereals: Occurrence, legislation, factors promoting the appearance and 
their management. Molecules 21, 627 (2016).
 32. Frizzell, C. et al. Endocrine disrupting effects of zearalenone, alpha-and beta-zearalenol at the level of nuclear receptor binding 
and steroidogenesis. Toxicol. Lett. 206, 210–217 (2011).
 33. Sobrova, P. et al. Deoxynivalenol and its toxicity. Interdiscip. Toxicol. 3, 94–99 (2010).
 34. Varga, J., Due, M., Frisvad, J. C. & Samson, R. A. Taxonomic revision of Aspergillus section Clavati based on molecular, mor-
phological and physiological data. Stud. Mycol. 73, iii–iii (2012).
 35. Frisvad, J. C., Smedsgaard, J., Larsen, T. O. & Samson, R. A. Mycotoxins, drugs and other extrolites produced by species in 
Penicillium subgenus Penicillium. Stud. Mycol. 49, 201–241 (2004).
 36. Puel, O., Galtier, P. & Oswald, I. P. Biosynthesis and toxicological effects of patulin. Toxins 2, 613–631 (2010).
 37. Houbraken, J., Samson, R. A. & Frisvad, J. C. Byssochlamys: significance of heat resistance and mycotoxin production. In Advances 
in Food Mycology (eds Houbraken, J. et al.) 211–224 (Springer, 2006).
 38. Mutegi, C. et al. Incidence of aflatoxin in peanuts (Arachis hypogaea Linnaeus) from markets in Western, Nyanza and Nairobi 
Provinces of Kenya and related market traits. J. Stored Prod. Res. 52, 118–127 (2013).
 39. Gong, Y. et al. Postweaning exposure to aflatoxin results in impaired child growth: A longitudinal study in Benin, West Africa. 
Environ. Health perspect. 112, 1334–1338 (2004).
 40. Lewis, L. et al. Aflatoxin contamination of commercial maize products during an outbreak of acute aflatoxicosis in eastern and 
central Kenya. Environ. Health Perspect. 113, 1763–1767 (2005).
 41. Reddy, K., Nurdijati, S. & Salleh, B. An overview of plant-derived products on control of mycotoxigenic fungi and mycotoxins. 
Asian J. Plant Sci. 9, 126 (2010).
 42. Tefera, T. Post-harvest losses in African maize in the face of increasing food shortage. Food secur. 4, 267–277 (2012).
 43. Odamtten, G. T., Nartey, L., Wiafe-Kwagyan, M., Anyebuno, G. & Kyei-Baffour, V. Resident microbial load, toxigenic potential 
and possible quality control measures of six imported seasoning powders on the Ghanaian market. J. Nutr. Health Food Eng. 8, 
24–35 (2018).
 44. Kortei, N. K., Tetteh, R. A., Wiafe-Kwagyan, M., Amon, D. N. K. & Odamtten, G. T. Mycobiota profile, phenology, and potential 
toxicogenic and pathogenic species associated with stored groundnuts (Arachis hypogaea L.) from the Volta Region, Ghana. 
Food Sci. Nutr. https://d oi. org/ 10. 1002/f sn3. 2719 (2022).
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 14
Vol:.(1234567890)
www.nature.com/scientificreports/
 45. Ahene, R., Odamtten, G. T. & Owusu, E. Fungal and bacterial contaminants of six spices and spice products in Ghana. Afr. J. 
Environ. Sci. Technol. 5, 633–640 (2011).
 46. Kottoh, D. Radiation decontamination of three local spices and khebab spice-mix and some aspects of their physiochemical 
and nutritional properties before and after gamma irradiation. MPhil Thesis, School of Nuclear and Allied Sciences, College of 
Basic and Applied Sciences, University of Ghana, Legon, pp 119 (2011).
 47. Wareing, P. W., Westby, A., Gibbs, J. A., Allotey, L. T. & Halm, M. Consumer preferences and fungal and mycotoxin contamina-
tion of dried cassava products from Ghana. Int. J. Food Sci. Technol. 36, 1–10 (2001).
 48. Minamor, A. A. & Odamtten, G. T. Radial growth of three Paecilomyces species isolated from two Ghanaian maize varieties 
Abeleehi and Obaatanpa on five different media and the effects of their culture filtrate on seed germination and radicle elonga-
tion of Abeleehi and Obaatanpa. Int. J. Curr. Microbiol. Appl. Sci. 5, 604–617 (2016).
 49. Minamor, A. A. & Odamtten, G. T. Influence of the culture filtrate of three Paecilomyces species on some growth parameters, 
chlorophyll content, and root anatomy of two Ghanaian maize varieties (Abeleehi and Obaatanpa) and on germination capacity 
of tomato and pepper seeds. Am. J. Microbiol. Res. 5, 51–58 (2017).
 50. Addo, A. Premilinary studies on the microbiological and nutrient quality of three local spices on the Ghanaian market and the 
control of resident microflora by gamma irradiation: BSc. BSc. Hons Dissertation, Department of Botany, University of Ghana, 
Legon (2005).
 51. Ofori-Appiah, D. Decontamination of sliced and powdered okra (Abelmoschus esculentus) and some aspects of nutrient quality 
before and after gamma irradiation. MPhil Thesis, School of Nuclear and Allied Sciences, College of Basic and Applied Sciences, 
University of Ghana, Legon, 197 (2012).
 52. Agyemang, A. Radiation preservation of tiger nut (Cyperus esculentus L.) with special reference to fungi and the effect on some 
aspects of the physico-chemical properties of the nuts before and after radiation MPhil Thesis. Radiation Processing, School of 
Nuclear and Allied Sciences, College of Basic and Applied Sciences, University of Ghana 172 (2011).
 53. Odamtten, G. T. Studies on the control of fungal contamination and aflatoxin production by Aspergillus flavus Link in a cereal grain 
by the combination treatment of heat and irradiation. PhD Thesis, Wageningen Agricultural University and Research Centres, 
Department of Food Science, Microbiology and Hygeine, PUDOC Publication. pp190 (Wageningen University and Research, 
1986).
 54. Odamtten, G. T., Appiah, V. & Langerak, D. Influence of inoculum size of Aspergillus flavus link on the production of aflatoxin 
B1 in maize medium before and after exposure to combination treatment of heat and gamma radiation. Int. J. Food Microbiol. 
4, 119–127 (1987).
 55. Odamtten, G.T. A survey of the mycoflora of maize grains stored at 26±3° C and 75±5% RH. In: Proceedings 12th Biennial Conf. 
of the Ghana Sci. Assoc.5–11th April, 1981, pp 14.
 56. Odamtten, G.T. Plant Diseases, Crop Production and Food Security in Ghana. Inaugural Lecture delivered as a fellow of the 
Ghana Academy of Arts and Sciences, GAAS, 22nd June 2017 (2017).
 57. Odamtten, G. T., Appiah, V. & Langerak, D. I. Preliminary studies of the effects of heat and gamma irradiation on the production 
of aflatoxin B1 in static liquid culture, by Aspergillus flavus link NRRL 5906. Int. J. Food Microbiol. 3, 339–348 (1986).
 58. Kortei, N. K. et al. The occurrence of aflatoxins and human health risk estimations in randomly obtained maize from some 
markets in Ghana. Sci. Rep. 11, 1–13 (2021).
 59. Kortei, N. K. et al. Exposure and risk characterizations of ochratoxins A and aflatoxins through maize (Zea mays) consumed in 
different agro-ecological zones of Ghana. Sci. Rep. 11, 1–19 (2021).
 60. Kpodo, K., Sørensen, A. & Jakobsen, M. The occurrence of mycotoxins in fermented maize products. Food Chem. 56, 147–153 
(1996).
 61. Kpodo, K. & Halm, M. Fungal and aflatoxin contamination of maize stored in silos and warehouses in Ghana (1990).
 62. Kpodo, K., Thrane, U. & Hald, B. Fusaria and fumonisins in maize from Ghana and their co-occurrence with aflatoxins. Int. J. 
Food Microbiol. 61, 147–157 (2000).
 63. Kpodo, K. A. Fusaria and Fumonisins in Maize and Fermented Maize Products from Ghana, Royal Veterinary and Agricultural 
University, Department of Dairy and Food (2001).
 64. Kpodo, K., Ayernor, G., Shephard, G. & Jakobsen, M. Exposure to fumonisins through Kenkey–a Ghanaian fermented maize 
product. Mycotoxins and phycotoxins, 209 (2006).
 65. Atter, A., Ofori, H., Anyebuno, G. A., Amoo-Gyasi, M. & Amoa-Awua, W. K. Safety of a street vended traditional maize bever-
age, ice-kenkey, in Ghana. Food Control 55, 200–205 (2015).
 66. Kumi, J. et al. Aflatoxins and fumonisins contamination of home-made food (weanimix) from cereal-legume blends for children. 
Ghana Med. J. 48, 121–126 (2014).
 67. Opoku, N., Achaglinkame, M. A. & Amagloh, F. K. Aflatoxin content in cereal-legume blends on the Ghanaian market far 
exceeds the permissible limit. Food Secur. 10, 1539–1545 (2018).
 68. Omari, R. & Anyebuno, G. Risk assessment of aflatoxins in maize-groundnuts complemen-tary foods consumed by Ghanaian 
infants. J. Food qual. Hazards Control https:// doi. org/ 10.1 8502/ jfqhc.7. 3. 4144 (2020).
 69. Kortei, N. K., Agyekum, A. A., Akuamoa, F., Baffour, V. K. & Alidu, H. W. Risk assessment and exposure to levels of naturally 
occurring aflatoxins in some packaged cereals and cereal based foods consumed in Accra Ghana. Toxicol. Rep. 6, 34–41 (2019).
 70. Blankson, G., Mills-Robertson, F. & Ofosu, I. Survey of occurrence levels of aflatoxins in selected locally processed cereal-based 
foods for human consumption from Ghana. Food Control 95, 170–175 (2019).
 71. Kortei, N. K. et al. Aflatoxins in randomly selected groundnuts (Arachis hypogaea) and its products from some local markets 
across Ghana: Human risk assessment and monitoring. Toxicol. Rep. 8, 186–195 (2021).
 72. Awuah, R. T. & Kpodo, K. A. High incidence of Aspergillus flavus and aflatoxins in stored groundnut in Ghana and the use of a 
microbial assay to assess the inhibitory effects of plant extracts on aflatoxin synthesis. Mycopathologia 134, 109–114 (1996).
 73. Bediako, K. A. et al. Prevalence of fungi and aflatoxin contamination in stored groundnut in Ghana. Food Control 104, 152–156 
(2019).
 74. Anyebuno, G., Kyei-Baffour, V. & Narh, D. Effect of manual sorting on Aflatoxins content in peanuts (Arachis Hypogaea, L) from 
a Ghanaian market. Ghana J. Agric. Sci. 52, 5–15 (2018).
 75. Omore, A. O. et al. Employment Generation Through Small-scale Dairy Marketing and Processing: Experiences from Kenya, 
Bangladesh and Ghana: A Joint Study by the ILRI Market-oriented Smallholder Dairy Project and the FAO Animal Production 
and Health Division (Food & Agriculture Org, 2004).
 76. Addo-Boadu, C. Aflatoxin M1 Contamination of Raw Cow Milk, Milk Products and Dietary Exposure (2019).
 77. Kortei, N. K. et al. Exposure assessment and cancer risk characterization of aflatoxin M1 (AFM1) through ingestion of raw cow 
milk in southern Ghana. Toxicol. Rep. 9, 1189–1197 (2022).
 78. Kortei, N. K. et al. Aflatoxin M1 exposure in a fermented millet-based milk beverage ‘brukina’and its cancer risk characterization 
in Greater Accra, Ghana. Sci. Rep. 12, 1–13 (2022).
 79. Kortei, N. K. & Annan, T. Aflatoxin M1 contamination of Ghanaian traditional soft cottage cheese (Wagashie) and health risks 
associated with its consumption. J. Food Qual. 2022, 1–12 (2022).
 80. Mensah, J., Owusu, E. & Anyebuno, G. Growth and production of aflatoxins by a flavus in aqueous fruit extracts of pepper, okra 
and tomato (2014).
 81. Anyebuno, G. Mycoflora and aflatoxin levels in millet samples from ten markets in Accra (2002).
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 15
Vol.:(0123456789)
www.nature.com/scientificreports/
 82. Kortei, N. K. et al. Mycoflora, aflatoxins, and antimicrobial properties of some Ghanaian local spices and herbs. J. Food Saf. 42, 
e12996 (2022).
 83. Kortei, N. K. et al. Toxicogenic fungi, aflatoxins, and antimicrobial activities associated with some spices and herbs from three 
selected markets in Ho municipality, Ghana. Int. J. Food Sci. 2022, 1–15 (2022).
 84. Kortei, N. K. et al. Dietary exposure to aflatoxins in some randomly selected foods and cancer risk estimations of cereals con-
sumed on a Ghanaian market. J. Food Qual. 2022, 1–11 (2022).
 85. Kpodo, K. A. & Bankole, S. A. Mycotoxin contamination in foods in West and Central Africa. Mycotoxins: Detection Methods, 
Management, Public Health and Agricultural Trade, CABI Publishing, Wallingford, UK, 103–116 (2008).
 86. Kyei-Baffour, V. O. et al. A validated HPLC–FLD method for the determination of mycotoxin levels in sun dried fermented 
cocoa beans: Effect of cola nut extract and powder. LWT 148, 111790 (2021).
 87. GS Service. 2010 Population & Housing Census Report: Urbanisation in Ghana (Ghana Statistical Service, 2014).
 88. Hymery, N. et al. Filamentous fungi and mycotoxins in cheese: A review. Compr. Rev. Food Sci. Food Saf. 13, 437–456 (2014).
 89. Udomkun, P. et al. Mycotoxins in Sub-Saharan Africa: Present situation, socio-economic impact, awareness, and outlook. Food 
Control 72, 110–122 (2017).
 90. Akpo-Djènontin, D. O. O., Gbaguidi, F., Soumanou, M. M. & Anihouvi, V. B. Mold infestation and aflatoxins production in 
traditionally processed spices and aromatic herbs powder mostly used in West Africa. Food Sci. Nutr. 6, 541–548 (2018).
 91. Hell, K. & Mutegi, C. Aflatoxin control and prevention strategies in key crops of Sub-Saharan Africa. Afr. J. Microbiol. Res. 5, 
459–466 (2011).
 92. Vismer, H. F., Shephard, G. S., Rheeder, J. P., van der Westhuizen, L. & Bandyopadhyay, R. Relative severity of Fumonisin con-
tamination of cereal crops in West Africa. Food Addit. Contam. 32, 1952–1958 (2015).
 93. Jonathan, S. G., Adeniyi, M. A. & Asemoloye, M. D. Fungal biodeterioration, aflatoxin contamination, and nutrient value of 
“suya spices”. Scientifica 2016, 1–6 (2016).
 94. Haruna, M. et al. Incidence of fungal flora and aflatoxin in some spices sold in central market, Funtua, Nigeria. UMYU J. Micro-
biol. Res. 2, 47–53 (2017).
 95. Chilaka, C. A., De Boevre, M., Atanda, O. O. & De Saeger, S. Occurrence of Fusarium mycotoxins in cereal crops and processed 
products (Ogi) from Nigeria. Toxins 8, 342 (2016).
 96. Njumbe Ediage, E., Hell, K. & De Saeger, S. A comprehensive study to explore differences in mycotoxin patterns from agro-
ecological regions through maize, peanut, and cassava products: A case study, Cameroon. J. Agric. Food Chem. 62, 4789–4797 
(2014).
 97. Magembe, K., Mwatawala, M., Mamiro, D. & Chingonikaya, E. Assessment of awareness of mycotoxins infections in stored 
maize (Zea mays L.) and groundnut (Arachis hypogea L.) in Kilosa district, Tanzania. Int. J. Food Contam. 3, 1–8 (2016).
 98. Mwangi, W. W., Nguta, C. M. & Muriuki, B. G. Aflatoxin contamination in selected spice preparations in the Nyahururu retail 
market, Kenya. J. Sci. Res. Rep. 3, 917–923 (2014).
 99. Kankolongo, M. A., Hell, K. & Nawa, I. N. Assessment for fungal, mycotoxin and insect spoilage in maize stored for human 
consumption in Zambia. J. Sci. Food Agric. 89, 1366–1375 (2009).
 100. Lukwago, F. B., Mukisa, I. M., Atukwase, A., Kaaya, A. N. & Tumwebaze, S. Mycotoxins contamination in foods consumed in 
Uganda: A 12-year review (2006–18). Sci. Afr. 3, e00054 (2019).
 101. Motloung, L. et al. Study on mycotoxin contamination in South African food spices. World Mycotoxin J. 11, 401–409 (2018).
 102. El-Tahan, F., El-Tahan, M. & Shebl, M. Occurrence of aflatoxins in cereal grains from four Egyptian governorates. Nahrung 44, 
279–280 (2000).
 103. El-Kady, I., El-Maraghy, S. & Mostafa, M. E. Natural occurrence of mycotoxins in different spices in Egypt. Folia Microbiol. 40, 
297–300 (1995).
 104. Kortei, N. et al. Knowledge and Attitude of consumers about natural food toxins: A case of tertiary students in the Volta region 
of Ghana. J. Food Qual. Hazards Control https:// doi. org/ 10.1 8502/ jfqhc.8. 3.7 196 (2021).
 105. Jere, G. M., Abong, G., Njue, L., Masamba, K. & Omayio, D. Exposure of school children to aflatoxins and fumonisins through 
maize-based diets in school meals programme in Salima District, Malawi. Afr. J. Food Agric. Nutr. Dev. 20, 16793–16809 (2020).
 106. Kamala, A. et al. Risk of exposure to multiple mycotoxins from maize-based complementary foods in Tanzania. J. Agric. Food 
Chem. 65, 7106–7114 (2017).
 107. Ezekiel, C. N. et al. Mycotoxins in uncooked and plate-ready household food from rural northern Nigeria. Food Chem. Toxicol. 
128, 171–179 (2019).
 108. Jolly, C. M., Bayard, B., Awuah, R. T., Fialor, S. C. & Williams, J. T. Examining the structure of awareness and perceptions of 
groundnut aflatoxin among Ghanaian health and agricultural professionals and its influence on their actions. J. Socio-Econ. 38, 
280–287 (2009).
 109. Lesuuda, L., Obonyo, M. A. & Cheserek, M. J. Determinants of knowledge about aflatoxin and fumonisin contamination in 
sorghum and postharvest practices among caregivers of children aged 6–59 months in Kerio Valley, Kenya. Food Sci. Nutr. 9, 
5435–5447 (2021).
 110. Azaman, N. N. M., Kamarulzaman, N. H., Shamsudin, M. N. & Selamat, J. Stakeholders’ knowledge, attitude, and practices 
(KAP) towards aflatoxins contamination in peanut-based products. Food Control 70, 249–256 (2016).
 111. Richard, J. L. Mycotoxins-an overview. Romer Labs Guide Mycotoxins 1, 1–48 (2000).
 112. Centers for Disease Control and Prevention. Outbreak of aflatoxin poisoning-eastern and central provinces, Kenya, January–July 
2004. MMWR Morb. Mortal. Wkly. Rep. 3, 790–793 (2004).
 113. Toma, A. Knowledge, attitude and practice of farmers’ towards aflatoxin in cereal crops in Wolaita zone, Southern Ethiopia. EC 
Nutr. 14, 247–254 (2019).
 114. Misihairabgwi, J., Ezekiel, C., Sulyok, M., Shephard, G. & Krska, R. Mycotoxin contamination of foods in Southern Africa: A 
10-year review (2007–2016). Crit. Rev. Food Sci. Nutr. 59, 43–58 (2019).
 115. Nicholaus, C., Martin, H., Matemu, A., Kimiywe, J. & Kassim, N. Risks of aflatoxin exposure among adolescents in boarding 
schools in Kilimanjaro region, Tanzania. World Mycotoxin J. 14, 221–235 (2021).
 116. Florkowski, W. J. & Kolavalli, S. Aflatoxin control strategies in the groundnut value chain in Ghana. IFPRI Ghana Strategy Sup-
port Program Working Paper 33 (2013).
 117. Gichohi-Wainaina, W. N., Kumwenda, N., Zulu, R., Munthali, J. & Okori, P. Aflatoxin contamination: Knowledge disparities 
among agriculture extension officers, frontline health workers and small holder farming households in Malawi. Food Control 
121, 107672 (2021).
 118. Ilesanmi, F. & Ilesanmi, O. Knowledge of aflatoxin contamination in groundnut and the risk of its ingestion among health work-
ers in Ibadan, Nigeria. Asian Pac. J. Trop. Biomed. 1, 493–495 (2011).
 119. Achaglinkame, M. A., Opoku, N. & Amagloh, F. K. Aflatoxin contamination in cereals and legumes to reconsider usage as 
complementary food ingredients for Ghanaian infants: A review. J. Nutr. Intermed. Metab. 10, 1–7 (2017).
 120. Nakavuma, J. L. et al. Awareness of mycotoxins and occurrence of aflatoxins in poultry feeds and feed ingredients in selected 
regions of Uganda. Int. J. Food Contam. 7, 1–10 (2020).
 121. Kortei, N. K., Asiedu, P., Annan, T., Deku, J. G. & Boakye, A. A. Fungal diversity of “solom” a Ghanaian traditional beverage of 
millet (Pennisetum glaucum). Food Sci. Nutr. https:// doi. org/1 0. 1002/ fsn3. 2045 (2020).
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 16
Vol:.(1234567890)
www.nature.com/scientificreports/
 122. Eric, O.-O. & Gyapong, A.-Y. The contribution of the ghana schools feeding programme to basic school participation: A study 
of selected schools in the Kwaebibirim district of Ghana. Dev. Ctry. Stud. 4, 40–50 (2014).
 123. Afoakwa, E. O. & Chiwona-Karltun, L. Building Sustainable Agricultural Development through Home-Grown School Feeding-
The African Approach (2008).
 124. Drake, L., Woolnough, A., Bundy, D. & Burbano, C. Global School Feeding Sourcebook: Lessons from 14 Countries (World scien-
tific, 2016).
 125. Atta, G. P. & Manu, J. Ghana school feeding program: A retrospective review. Int. J. Innov. Res. Dev. 4, 402–410 (2015).
Acknowledgements
We acknowledge and sincerely extend our heartfelt appreciation to Mr. Philemon Yaw Atsugah formerly of 
the Department of Food Science and Technology, Ho Technical University for his enormous effort in the data 
collection process. A big thank you also goes to all the respondents who participated in this research for their 
immense contribution. Lastly, to the staff of the Department of Nutrition and Dietetics, University of Health 
and Allied Sciences for their support.
Author contributions
N.K.K., G.T.O., S.B., S.N., and. M.W.-K. performed the experiments and wrote the manuscript. S.N., N.K.K., 
G.T.O. were responsible for statistical analysis. G.T.O., N.K.K., M.W.-K. and D.N.K.A. helped conceive the 
experiments and prepared the manuscript. N.K.K., S.B., S.N., M.W-K. and G.T.O. conceived the original study 
and N.K.K., G.T.O., S.N. and D.N.K.A. led the sampling and study in Ghana. All authors read and approved the 
final manuscript.
Competing interests 
The authors declare no competing interests.
Additional information
Correspondence and requests for materials should be addressed to N.K.K.
Reprints and permissions information is available at www.nature.com/reprints.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and 
institutional affiliations.
Open Access  This article is licensed under a Creative Commons Attribution 4.0 International 
License, which permits use, sharing, adaptation, distribution and reproduction in any medium or 
format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the 
Creative Commons licence, and indicate if changes were made. The images or other third party material in this 
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the 
material. If material is not included in the article’s Creative Commons licence and your intended use is not 
permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from 
the copyright holder. To view a copy of this licence, visit http:// creati vecom mons.o rg/ licen ses/ by/4.0 /.
© The Author(s) 2023
Scientific Reports |         (2023) 13:8710  | https://doi.org/10.1038/s41598-023-35275-5 17
Vol.:(0123456789)