Inorganic binder (P-score 0.8615) was ranked to be the most efficient in terms of counteracting the toxic effect of aflatoxins, followed by antioxidant (P-score 0.6159) and organic binder (P-score 0.5018). Supplementing aflatoxin-contaminated feeds with different categories of additives significantly reduces serum ALT levels ( p < 0.001) compared with birds fed only a contaminated diet. Moreover, alanine transaminase (ALT), a liver enzyme, was the primary indicator. Additives were classified into three categories based on their mode of action and composition: organic binder, inorganic binder, and antioxidant. Eligible studies on the efficacy of feed additives to mitigate the toxic effect of aflatoxins in poultry were retrieved from different databases. This systematic review and network meta-analysis aim to compare and identify the most effective intervention to alleviate the negative impact of aflatoxins on the important livestock sector, poultry production. They can also be excreted in milk and thus pose a significant human health risk. Exposure of animals to an aflatoxin-contaminated diet impairs feed efficiency and increases susceptibility to diseases, resulting in mortality, feed waste, and increased production costs. The contamination of animal feed with aflatoxins is an ongoing and growing serious issue, particularly for livestock farmers in tropical and subtropical regions.
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