Serum Aflatoxin-Albumin Adduct Profiling and Exposure Predictors Among Gastroenterology Patients of Tertiary Hospitals in Southwestern Nigeria.

Aflatoxin, a potent hepatocarcinogenic mycotoxin, remains a major public health concern in sub-Saharan Africa. Due to its severe health and socio-economic impact, aflatoxin exposure needs to be monitored and mitigated. This cross-sectional study assessed serum aflatoxin-albumin adducts (AF-ALB), an objective biomarker of systemic aflatoxin exposure, among gastroenterology patients in southwestern Nigeria using ELISA. AF-ALB levels were categorized into high and low groups based on interquartile ranges. Multivariate logistic regression was used to identify socio-demographic, dietary, and temporal predictors. Of the 573 participants, 405 (70.7%) were male, and 168 (29.3%) were female. Overall median AF-ALB concentration was 3.5 pg/mL. Daily groundnut consumption showed the strongest dietary association (aOR= 9.7, 95% CI: 4.3-21.9, p < 0.001), while the sampling period was also significantly associated with AF-ALB levels (p < 0.001). The association between urban residence and high AF-ALB levels was model-dependent rather than a true independent association. AF-ALB median levels varied significantly across gastroenteric diseases (p < 0.001, Cramer's V = 0.478). Age, sex, education, occupation, marital status, and aflatoxin awareness status were not significantly associated with AF-ALB levels. These findings indicate that dietary practices, particularly frequent groundnut consumption, are important predictors of aflatoxin exposure in this population.