Across sub-Saharan Africa, the heavy reliance on mycotoxin-susceptible staple foods means that populations in the region are particularly vulnerable to chronic mycotoxin exposure. This study assessed the exposure risk to ochratoxin A (OTA) and aflatoxins (AFs) from 18 samples of selected staple foods (maize, millet, groundnut) and 56 fresh cow milk samples collected from across Ghana. The foods were sampled simultaneously to maximise comparability, and at two timepoints in March/April (during the dry season) and July/August (during the rainy season) to assess the effects of duration of storage and seasonal conditions on the mycotoxin levels as measured by high-performance liquid chromatography. The margin of exposure (MOE) approach was used to assess the exposure risk from consumption of the sampled foods. Each of the sampled staples was contaminated with OTA (0.19–3.11 ng/g) and at least one AF (0.75–13.05 ng/g B1, ND-12.12 ng/g B2, 0.1–9.95 ng/g G1, ND-16.78 ng/g G2). Up to 67% had contamination above European Food Safety Authority (EFSA) maximum limits, and 50% were above Ghana Standards Authority (GSA) limits. The fresh cow milk samples were contaminated with AFM1 in the range of 0.05–1.49 ng/g, with 95% above EFSA limits and 36% above GSA limits. Aflatoxin contamination in the staples was high, particularly in July/August when the wet conditions may have adversely impacted the handling and storage of farm produce. Variation in AFM1 between the two sampling periods mirrored total aflatoxin in the staples, suggesting that even if dairy cattle were grazing in open pasture and not being rationed on stored feed, then there was a high environmental presence of aflatoxigenic fungi. The MOE estimates were ≤533.09, far below the safe cut-off of 10,000 for suspected carcinogenic compounds. The high mycotoxin levels indicate a priority risk to child nutrition which relies heavily on cereal mixes based on one or all the three sampled staples. The data from this study underscore the urgent need for interventions to better appreciate and address mycotoxin exposure for enhanced food security and public health in Ghana and across sub-Saharan Africa.
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