Food Safety Practice and Its Associated Factors among Mothers in Debarq Town, Northwest Ethiopia: Community-Based Cross-Sectional Study

Assessment of the knowledge, attitude, and practice of childbearing mothers in the geographically coastal region of Bangladesh for cleanliness and food safety of food security

Objectives

Household hygiene and food safety are essential parts of food security; better food safety and hygiene will help reduce the chances of illness for young children and family members rarely studied in the selected area of coastal Bangladesh. The study aimed to discover the knowledge, attitude, and practice levels for cleanliness, hygiene, and food safety in the household.

Methods

In this study, we employed a cross-sectional survey with simple random sampling to collect data from 384 childbearing mothers. The survey used the pretested, validated, and standardized (knowledge, attitude, and practice) questionnaire-model-based interview guide.

Results

According to our study analysis, the knowledge, attitude, and practice scores among mothers were inadequate for household cleanliness and hygiene management. In the area context, knowledge efficiency was related to family type (joint and nuclear). Family economic conditions strongly influenced mothers' attitudes and behavior toward knowledge, attitude, and practice score. Unemployed and illiterate mothers have lower knowledge, attitude, and practice scores. Educated mothers have better knowledge, attitude, and practice score compared to illiterate mothers (p < 0.014). Nuclear family knowledge, attitude, and practice attitude was much greater (p < 0.04) and wealthier families showed better practice (p < 0.001) toward cleanliness and food safety in the household level.

Conclusions

The study discovered the mothers' and household members' attention need to improve the knowledge, attitude, and practice toward proper hygiene and food safety at the household level of marginalized populations in coastal Bangladesh.

Evaluation of Food Safety Knowledge and Attitudes Among Adults in the United Arab Emirates

Background Food is handled by many individuals in large food setups, therefore increasing the chance of contamination that leads to foodborne diseases (FBDs). This study was purposed to evaluate adults' understanding of food safety, FBDs, and hygiene practices across various demographic groups in the United Arab Emirates (UAE) and to explore the link between their knowledge of food safety and their corresponding attitudes. Methods A cross-sectional study was conducted with 402 adults using a validated, self-administered questionnaire available in both printed and online formats. The study was carried out at Gulf Medical University and Thumbay hospitals and clinics over six months, beginning in December 2022 to June 2023. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). The chi-squared test was employed to examine the association between variables, and significant associations were further analyzed through logistic regression. Results Out of the 402 participants, the population was predominantly female 275 (67.9%), and from Southeast Asia 222 (55.4%), with students comprising the largest occupational group 186 (47%). Only 106 (26.36%) had received food safety training, and a mere 187 (46.51%) demonstrated adequate knowledge. Awareness levels varied, with the highest for raw food safety (64.02%) and the lowest for canned foods (40.79%). Demographic analysis revealed significant associations: males exhibited more inadequate knowledge 79 (62.2%) than females 136 (49.4%), and students showed higher inadequacy 104 (55.9%) compared to healthcare workers 31 (35.6%). Positive attitudes towards food safety were prevalent 226 (56.2%), and positive attitudes were found in women 157 (57.1%), individuals above 30 years of age 110 (50.5%), individuals working in healthcare 140 (62%), and married individuals 117 (60.9%). With a strong correlation (p<0.001), women were 1.68 times more likely to possess adequate knowledge than men (95% CI: 1.09, 2.59), and healthcare workers were 2.33 times more likely than students (95% CI: 1.37, 3.95). Conclusion The study reveals a low level of knowledge about food safety among adults in the UAE. Therefore, emphasis should be placed on increasing awareness of these concepts to reduce the burden of FBDs on the healthcare system.

Food hygiene and food safety practices of households in a township north of Tshwane, Gauteng

Background

Foodborne illness is still a major public health concern worldwide. Most cases of foodborne illness can be traced to the home. The food safety practices of food handlers in the household are an important determining factor in food safety at the household level.

Aim

To assess the food safety practices of food handlers in households in Ga-Rankuwa, Tshwane.

Setting

The study was conducted in zones 1-9 and zone 16, as well as extension 25 of Ga-Rankuwa, Tshwane.

Methods

A quantitative descriptive study design was used for which a structured questionnaire was administered among 339 food handlers. Descriptive and inferential statistical analysis was performed in STATA 13.1.

Results

The majority of food handlers reported always washing their hands before (81%) and after handling raw meat, chicken or fish; the majority of food handlers (69%) reported always washing preparation surfaces and utensils with clean, soapy water after handling raw meat, chicken or fish. Less than half (45%) of food handlers reported never thawing frozen meat, chicken or fish in a bowl of cold water.

Conclusion

The food handlers reported appropriate food safety practices regarding hand washing and food preparation surfaces and utensils. However, their practices regarding the storage of meat, chicken and fish were inappropriate.

Contribution

This study builds on the existing body of literature on the food safety practices of food handlers. Moreover, the study findings can serve as a basis for the development of interventions to ensure food safety at a household level.

Food Safety Practice and Associated Factors of Food Handlers Working in Food Industries in Bahir Dar City, Amhara Regional State, Northwest Ethiopia, 2021

BACKGROUND

Food safety has emerged as one of the 10 threats to global health. Ethiopia is among the developing countries with many food industries in recent times. Poor food handling procedures, a lack of basic infrastructure, lack of potable water, lack of financial resources to invest in safer equipment, and lack of training for food handlers have all been reported.

OBJECTIVES

To assess food safety practices and associated factors among food handlers working in food industries in Bahir Dar city administrations.

METHODS

A cross-sectional study was conducted from January to February 2021 among 422 food handlers working in food industries in Bahir Dar city, Ethiopia. A random sampling technique was used to select food industries and study participants. The sample size was proportionately allocated to the selected food industries. Data were collected through face-to-face interviews and observation methods using interviewer-administered questionnaires and an observational checklist respectively. Data was entered into Epi-data v 3.1 and exported to SPSS v 23 for analysis. Bi-variable binary logistic regression was carried out to identify candidate variables at p-value <.2 and was entered into the final multivariable binary logistic regression model to control the effect of confounding. Variables with p-values of less than .05 were declared as statistically significant and an odds ratio of 95% CI was used to measure the strength of the association.

RESULT

Food safety practice among food handlers working in food industries was 47.6% (95% CI: 42.8, 52.5). Sex [AOR: 2.92 (CI: 1.77, 4.82)], monthly salary [AOR: 2.02 (CI: 1.18, 3.44)], health supervision [AOR: 3.43 (CI: 1.97, 5.97)], working unit [AOR: 2.44, (CI: 1.45, 4.13], food safety training [AOR: 6.16 (2.97, 12.77)], attitude [AOR: 3.55 (CI: 1.14, 11.05)] were factors significantly associated with food safety practice.

CONCLUSION

Food safety practice among food handlers was low. Sex, working unit, monthly income, regulatory supervision, food safety training, and attitude toward food safety were factors associated with poor food safety practices. In-service training on good hygiene practices, good manufacturing practices, hazard analysis, critical control point, food safety management systems, and supportive supervision should be strengthened.

Food handlers' practices and associated factors in public food establishments in Gondar, Ethiopia 2021/2022

Food safety is crucial to avoid foodborne illness and improve human wellbeing. Millions of people get sick, and many of them pass away due to eating unhealthy food. Foodborne diseases are still a public health problem in developing countries like Ethiopia. The objective of this study was to assess food handlers' practices and associated factors in public food establishments in Gondar, Northwest Ethiopia. Across-sectional study was conducted among 417 food handlers in food and drink service establishments. The data were collected using a structured interview-administered questionnaire and an observational checklist. Multivariable logistic regression was used to identify predictors. The prevalence of food safety practice among food handlers was 37.6%, with a 95% CI of (32.9, 42.7). More than half of the study participants had good knowledge and attitude. Sex (female) [AOR = 0.40, 95%CI: (0.23, 0.92)], educational status (diploma and above) [AOR = 1.50, 95%CI: (1.21, 3.10)], and good attitude [AOR = 0.25 95%CI: (0.12, 0.89)] were predictors of food safety practices. The prevalence of food safety practices among food handlers in Gondar food establishments was low. The provision of education and on-the-job training on food safety and personal hygiene is advised to enhance good food handling practices.

Food Hygiene Practices and Associated Factors Among Street Food Vendors in Urban Areas of Gedeo Zone, Southern Ethiopia

Background

Street food is expanding all around Ethiopia. Street vendors have become commonplace near schools, hospitals and bus stations. Because street vended food is sold in unsanitary surroundings near streets, it can be contaminated with variety of pathogens, exposing consumers to foodborne illnesses. There haven't been enough studies on Ethiopian street food, and little is known about how hygienic these foods are. The local authorities don't even have a regulatory system to ensure food safety for street food vendors. Thus, this study aimed to assess food hygiene practices among street food vendors and associated factors.

Methods

Community-based cross-sectional analytical study design was conducted from June, 2021 to July, 2021 including 402 respondents. Structured questionnaire and observational checklists were used for assessing food hygiene practices. Data were analyzed using SPSS statistics (version 25.0). Binary logistic regression analyses were used to check association of covariates with food hygiene practices. Adjusted odds ratio, and P-value less than 0.05 at 95% confidence interval were used to report significant association.

Results

Out of 402, 390 individuals responded. About 123 (31.5%) (95% CI: 27.2-36.4) of vendors had good food hygiene practices. Being female (AOR = 0.15; 95% CI: 0.09-0.27), age (19-25 years (AOR = 0.29; 95% CI: 0.11-0.81) and 26 to 35 years (AOR = 0.24; 95% CI: 0.08-0.74), marital status (being married (AOR = 0.52; 95% CI: 0.29-0.93), educational status (college and above (AOR = 3.42; 95% CI: 1.35-8.62), monthly income (1001-2000 Ethiopian Birr (AOR = 0.36; 95% CI: 0.19-0.68), being inspected (AOR = 13.15; 95% CI: 2.76-62.66) and lack of water at vending site (AOR = 0.40; 95% CI: 0.17-0.97) were factors significantly associated with food hygiene practices of street vendors.

Conclusion

Few street food vendors who adhered to good food hygiene were present. Significant variables of food hygiene behaviors included gender, age, marital status, education level, monthly income, inspection frequency, and the availability of water at vending sites. The vendors' food hygiene practices needed to be improved, which necessitated continual assistance, frequent inspections, and public awareness campaign.

Food Safety Practices and Associated Factors in Food Operators: A Cross-Sectional Survey in the Students’ Cafeteria of Woldia University, North Eastern Ethiopia

The food safety issue is often overlooked in countries where food shortages, natural disasters, political tensions, and other major concerns dominate government and media agendas. As a result, the current study sought to assess food safety practices and associated factors among food handlers at Woldia University’s student cafeteria. An institutional cross-sectional study was conducted between May and July 2021, and a sample of 291 subjects was recruited through a simple random sampling technique. Questionnaires, focus group discussions, interviews, and observation methods were used as data collection tools. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20 software. Bivariate and multivariate logistic regressions were used to determine the effect of various factors on the outcome variable and control for confounding effects. $p<0.05$ was considered statistically significant. However, some variables are significant even at $p<0.001$ . The results were described by frequencies and percentages. The current study found that the factors of not having had food hygiene training ( $\text{AOR}=2.111$ , 95% $\text{CI}=\left(1.029-4.428\right)$ ), less than or equal to one year of work experience ( $\text{AOR}=3.070$ , 95% $\text{CI}=\left(2.020-10.246\right)$ ), poor knowledge ( $\text{AOR}=1.285$ , 95% $\text{CI}=\left(0.125-0.849\right)$ ) and poor attitude ( $\text{AOR}=1.190$ , 95% $\text{CI}=\left(1.361-9.393\right)$ ), not keeping cooked food at a safe temperature ( $\text{AOR}=3.037$ , 95% $\text{CI}=\left(1.021-12.096\right)$ ), failure to respect the safety of cooking utensils and surfaces ( $\text{AOR}=2.022$ , 95% $\text{CI}=\left(1.551-9.689\right)$ ), insufficient cleanliness of eating areas ( $\text{AOR}=2.430$ , 95% $\text{CI}=\left(1.983-6.217\right)$ ), not covering hair when cooking food ( $\text{AOR}=5.903$ , 95% $\text{CI}=\left(2.243-9.621\right)$ ), and not washing hands before starting to handle food ( $\text{AOR}=10.019$ , 95% $\text{CI}=\left(4.031-24.063\right)$ ) were statistically associated with unhygienic food handling practices. The results of this study indicated that the state of food safety practices was poor. Therefore, food safety assurance must comply with modern food safety frameworks such as Hazard Analysis and Critical Control Points (HACCP). In addition, addressing knowledge and skill gaps among food handlers, regular inspection services, and effective enforcement of food safety regulations are extremely essential. Finally, future studies should focus on enumerating bacteria and protozoa in unsanitary foods and utensils.

Food Safety Practice and Its Associated Factors among Meat Handlers in North Shewa Zone, Oromia, Ethiopia

Background

Foodborne illness is one of the major public health problems globally. The majority of foodborne diseases arise from foods of animal origin. Hence, this study was proposed to evaluate meat handling practices and associated factors working in butcher shops in North Shewa Zone.

Methods

Data were collected through face-to-face interviews using a pretested structured questionnaire. Data were entered into a computer and analyzed using SPSS version 26. Binary logistic regression was used to identify factors associated with meat handling practice.

Result

The majority, 128 (57.1%), of meat handlers smoke in workplaces, and 20 (8.9%) of meat handlers handled money while processing meat. 180 (80.4%) of meat handlers process/handle meat when they had cuts, wounds, bruises, or injuries on their hands. 12.1% and 15.6% of meat handlers took food safety training and medical checkups, respectively. 51.3% of meat handlers had good meat handling practices. Knowledge (adjusted odds ratio [AOR] 2.99, 95% confidence interval [CI] 1.73-5.15), attitude (AOR = 1.94, 95% CI: 1.12-3.37), experience (AOR = 4.27, 95% CI: 2.34-9.85), medical checkup (AOR = 3.87, 95% CI: 1.67-8.96), and educational status (AOR = 5.50, 95% CI: 1.05-28.75) were significantly associated with meat handling practices.

Conclusions

Food hygiene training before employment and awareness creation for meat handlers should be strengthened. Routine inspections by responsible authorities are also recommended. Future studies should focus on the enumeration of bacterial load from utensils and meat handlers.

The Influence of Selected Food Safety Practices of Consumers on Food Waste Due to Its Spoilage

Food waste in households is a consequence of the accumulation of improper practices employed by consumers when dealing with food. The survey estimated the impact of practices of Polish respondents, in the context of selected food safety and hygiene issues, on throwing away food due to spoilage. The survey was conducted in 2019, in a random quota-based, nationwide sample of 1115 respondents 18 years old and older. Synthetic indicators (SI) were created to assess the knowledge and practices of Polish adult respondents concerning selected areas of food management and the frequency of throwing food away. Most food products were not thrown away at all or were thrown away occasionally. Regression analysis revealed that the frequency of throwing food away was to the greatest extent related to food spoilage (β = 0.223). Among the five areas of Polish respondents’ practices covered by the analysis, the most conducive to wasting food due to spoilage were improper proceedings with food after bringing it home (β = 0.135; p = 0.000), a failure to ensure proper food storage conditions (β = 0.066; p = 0.030), or inappropriate proceedings with uneaten meals, excluding the food plate (β = 0.066; p = 0.029). To reduce food waste in Polish households, drawing the attention of consumers to the conditions of food storage at home seems appropriate. It is also vital to convince them to use freezing of uneaten food as an effective method of extending the life of food products.

Food hygiene practices and determinants among food handlers in Ethiopia: a systematic review and meta-analysis

Background

Food-borne diseases are a major public health concern worldwide, particularly in low and middle-income countries (LMICs), such as Ethiopia. Poor food hygiene practices primarily exacerbate food-borne illness transmission. Prior studies on the food hygiene practices among food handlers in Ethiopia were inconsistent. Therefore, this meta-analysis and systematic review aimed to estimate the pooled proportion of good food hygiene practices and identify the determinants in Ethiopia.

Methods

The preferred reporting items for systematic review and meta-analysis (PRISMA) instruments were used, and a systematic search was performed in the PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar were systematically last searched on the 24th February 2022 for relevant articles. Only the observational studies that reported the proportion of good food hygiene practices and their associated factors among food handlers were included. The quality of the included studies was assessed by two independent authors. Articles with unclear methodologies and did not report the overall proportions of good food hygiene practice were excluded. The effect estimates for pooled proportion and pooled odds ratio (POR) along with a 95% confidence interval (CI) were determined conducting using DerSimonian–Laird's random effect model.

Results

Among 817 retrieved studies, 23 eligible articles with a total sample size of 7153 study participants were included in the meta-analysis. The pooled proportion of good food hygiene practices among food handlers was 50.5% [95% CI: (41.6, 59.4%]; I² = 98.7%, p value = 0.001]. Food handlers with formal education (POR = 4.60, 95% CI: 3.05, 6.93), good knowledge (POR = 1.98, 95% CI: 1.26, 3.11), training (POR = 3.52, 95% CI: 2.35, 5.28), and a positive attitude (POR = 3.41, 95% CI: 2.52, 4.61) about food hygiene components, as well as regular medical checkups (POR = 6.75, 95% CI: 4.49) were significantly associated with good food hygiene practice.

Conclusions

Only half of Ethiopia's food handlers had good food hygiene practice.

Implication of the study

The key elements of effective food hygiene practice that will aid in the development of feasible interventions to increase food handler compliance with food hygiene components have been identified.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41182-022-00423-6.

The Association Between Bangladeshi Adults' Demographics, Personal Beliefs, and Nutrition Literacy: Evidence From a Cross-Sectional Survey

Background

Poverty and health illiteracy, combined with inappropriate systems to track disease and infection rates, contribute to children-and-mothers' poor adherence to nutrient-rich foods intake in Bangladesh. Although risk factors for child and pregnant women malnutrition have been explored, the relationship between Bangladeshi adults' nutrition literacy and their demographics and personal beliefs remains unknown. The purpose of this study was to examine the association between adults' nutrition literacy, demographics and personal beliefs in a large sample of Bangladeshi adults.

Methods

Four hundred adults from two districts (Dhaka and Chattogram) of Bangladesh participated in a cross-sectional survey. Data were collected by interviews using a structured questionnaire containing the Nutrition Literacy Scale. Multiple linear regression models were employed to analyze associations between nutrition literacy and related factors.

Results

The mean nutrition literacy score was 21.6 (SD: 3.7; range: 11-32) on a scale of 32. Multiple linear regression revealed that being a businessman (β = 1.66, p = 0.013) or private employee (β = 1.08, p = 0.030), having a higher family income (β = 1.17, p = 0.009), and a higher educational level were positively associated with higher nutrition literacy scores compared to their counterparts. Participants who had ever completed a nutrition-related course (β = 4.95, p < 0.001), and who perceived themselves as having a need for accessing nutrition-related information were positively associated with the higher nutrition literacy compared to their counterparts.

Conclusion

Findings from this study suggest the need for an integrated response plan involving educational interventions and accessible dietary plans targeting adult populations to enhance their nutritional literacy.

Food handling practice and associated factors among food handlers in public food establishments of Ethiopia: a systematic review and meta-analysis

OBJECTIVES

Food handlers are individuals who are involved in food preparation, storage or service of food in a food facility. Unless they keep their personal hygiene, they are highly responsible for contaminating food or transmitting microbes to consumers. Thus, the main aim of this review was to pool the level of good food handling practice among food handlers working in public food establishments in Ethiopia.

DESIGN

A systematic review and meta-analysis using the Joanna Briggs Institute (JBI) Critical Appraisal tool.

DATA SOURCES

PubMed, Google Scholar and Advanced Google were searched up to the end of February 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Publication status, publication language, type of study participants and the type of article were used to screen the article.

DATA EXTRACTION AND STUDY QUALITY ASSESSMENT

All reviewers collected data independently and merged them together. A tool called the JBI Meta-Analysis of Statistics Assessment and Review Instrument was used to assess the quality of each research article. The assessment was performed by two reviewers.

RESULT

A total of 16 research articles were included in the review. The pooled level of good food handling practice was 50.72% with 95% CI (43.84% to 57.6%). Training (adjusted OR (AOR)=3.4, 95% CI (2.33 to 4.95)), attitude (AOR=3.62, 95% CI (2.23 to 5.85)) and medical check-up (AOR=5.12, 95% CI (2.93 to 8.95)) were identified as factors affecting good food handling practice with 95% CI at p<0.05.

CONCLUSION

The level of good food handling practice among food handlers working in public food establishments of Ethiopia was very low compared with literature, and variables such as food handler training, attitude towards good food handling practice and the existence of regular medical check-ups were factors affecting good food handling practice. Provision of training that could change the attitude and regular medical check-ups for food handlers has to be in place.

Self-Reported Food Safety Practices and Associated Factors Among Health Extension Model and Non-Model Households in Northeastern Ethiopia: A Comparative Cross-Sectional Study

Purpose

Eating contaminated food continues to cause numerous food-borne diseases globally. Understanding the causes of poor food safety practices is key to preventing food-borne diseases. Therefore, this study aimed to assess the prevalence of food safety practices and associated factors among health extension model and non-model households in Kombolcha, Ethiopia.

Methods

A comparative cross-sectional study was conducted among 327 model households and 329 non-model households in Kombolcha. Four kebeles were selected randomly from a total of 12 kebeles, followed by a systematic random sampling method to select a total of 656 households. The data were collected through face-to-face interviews with household heads and observations from April 15 to May 15, 2021. Data were entered into EpiData version 3.1 and analyzed using SPSS version 25.0. Determinants of food safety practices were determined by using multivariable logistic regression model at a p-value <0.05.

Results

The overall prevalence of food safety practices was 44.7% (95% CI: 40.5-48.4%), of which 57.8% (95% CI: 53.0-63.1%) were model and 31.6% (95% CI: 26.5-36.7%) were non-model households, with significant variation among household types. Being a model household (AOR=2.99; 95% CI: 1.98-4.52), having a female household head (AOR=3.13; 95% CI: 2.13-4.59), proper solid waste management (AOR=2.32; 95% CI: 1.54-3.48), good knowledge of food safety (AOR=2.05; 95% CI: 1.43-3.03), and good attitude (AOR=1.74; 95% CI: 1.22, 2.49) were significant predictors of good food safety practices.

Conclusion

The prevalence of good food safety practices was not satisfactory. Being a model household, having a female household head, proper solid waste management, good knowledge, and good attitude were significantly associated with good food safety practices. Therefore, the identified modifiable factors are potential areas of intervention to enhance good food safety practices.

Understanding Domestic Food Safety: An Investigation into Self-Reported Food Safety Practice and Associated Factors in Southern Ethiopian Households

BACKGROUND

According to available studies, 12%-20% of reported foodborne outbreaks start in the household. It is projected that 1 out of every 10 persons will become ill as a result of consuming tainted food. Poor food handling practices cause 600 million foodborne illnesses each year. In a given year, this leads to 420 000 deaths. In Ethiopia, there is a scarcity of studies on home-food-safety practices and the factors that affect them. This has resulted in a shortage of relevant information on the status of home-food-related illnesses in the country.

METHODS

A community-based cross-sectional study was carried out from May to June 23, 2021. A standardized and pre-tested questionnaire was used to collect data from 622 households. The total plate count method was used to analyze bacteria on cleaned plates. Epi data version 3.1 was used to enter data, while SPSS version 25 was used to analyze the data. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with food safety practices.

RESULT

51.1% of the study participants had a safe food handling practice. The mean total plate count was 2.34 CFU/cm². In the multivariable regression, Household wealth (AOR = 2.05, 95% CI [1.01-3.16]), Education (AOR = 3.33, 95% CI [1.41-6.31]), Training (AOR = 2.85, 95% CI: [1.31-3.19]), Knowledge of safe practices (AOR = 1.95, 95% CI [1.23-3.08], and Attitude (AOR = 2.04, 95% CI [1.09, 3.82]) were associated with safe food handling practices.

CONCLUSION

Although data gathering systems for food-borne diseases typically overlook a large number of home-based outbreaks of sporadic infection, it is now widely understood that many episodes of food-borne sicknesses are caused by individuals' inappropriate food handling and preparation in their kitchens. In the current study, educational status, household wealth, food safety training, attitude, and knowledge about FBDs were found to be strongly associated with safe practices. This implies that public education is a key factor in improving food safety practices at home.

Hygienic Food Handling Practices and Associated Factors Among Food Handlers in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

The food handling practices of food handlers can have a significant impact on the hygienic status of the food. The aim of this study was to determine the prevalence and factors associated with hygienic food handling practices among food handlers in Ethiopia.

METHODS

PubMed, Science Direct, Google Scholar, and the Cochrane Library databases were used to find articles. Only cross-sectional studies that met the criteria for inclusion were considered. STATA version 16 statistical software was used to perform the meta-analysis. The study's heterogeneity was determined using Cochrane Q test statistics and the I ² test. A random effect model was used to calculate the pooled prevalence of hygienic food handling practices.

RESULTS

To estimate the pooled prevalence of hygienic food handling practices in Ethiopia, 9 out of 33 reviewed studies were included. The prevalence of hygienic food handling practices was found to be 48.36% (95% CI: 39.74-56.99) in this study. Factors associated with hygienic food handling practices included; lack of food safety training (OR = 5.38; 95% CI: 1.71, 16.89), negative attitude (OR = 3.28; 95% CI: 1.50, 7.13), lack of access to handwashing facilities (OR = 4.84; 95% CI: 1.72, 13.65), lack of regular medical checkup (OR = 5.37; 95% CI: 3.13, 9.23), and lack of secondary education (OR = 2.51; 95% CI: 1.46, 4.32) among food handlers.

CONCLUSION

In this study, the prevalence of hygienic food handling practices among Ethiopian food handlers was significantly low. Unhygienic food handling practices were attributed to a lack of food safety training, regular medical checkups, handwashing facilities, an unfavorable attitude toward food hygiene practices, and a lack of formal education. As a result, food handlers should receive ongoing food safety and hygiene training.

Cross sectional study on food safety knowledge, attitudes, and practices of food handlers in Lahore district, Pakistan

Annually, millions of the people suffer from foodborne diseases which are mainly associated with poor food handling practices. The poor food safety knowledge and practices increase the risk of food contamination and foodborne diseases. The aim of this study was to evaluate the relationship between demographic attributes and food safety knowledge, attitudes, and practices (KAP) of food handlers (chefs and servers) working in small-scale restaurants, hotels and eateries in Lahore, Pakistan. A structured questionnaire including questions related to demographic characteristics and food safety KAP attributes of food handlers (n = 202) was used to collect the responses. The responses of food handlers were statistically analyzed using Spearman Correlation and Chi-Square tests. The results showed that a large proportion of food handlers had good attitudes towards food safety and followed good food safety practices (FSP) but had poor food safety knowledge (FSK). Demographic characteristics of food handlers i.e. level of education, professional category, current job tenure, and total food service industry experience were significantly (p < 0.05) associated with FSK, FSA, and FSP. FSK was found to be moderate to strongly correlated with FSP of food handlers (rs = 0.675), whereas FSA was found to be strongly correlated with FSP (rs = 0.733). The study highlighted the importance and impact of food safety knowledge on food safety practices and overall perspective of food handlers working in restaurants.

Knowledge, Attitudes, and Practices towards Food Poisoning among Parents in Aseer Region, Southwestern Saudi Arabia

Background: Food poisoning is caused by eating contaminated food. Improper food safety knowledge, poor food handling, and inadequate personal hygiene may allow microbes to grow in sufficient numbers to cause a food-borne illness. The aim of this paper was to assess the knowledge, attitudes, and practices regarding food poisoning and its determinants of parents in the Aseer region of Saudi Arabia. Methodology: This is a descriptive cross-sectional study conducted on 3011 parents in the Aseer region in the southwest region of Saudi Arabia. An online questionnaire was used to collect the data. The level of knowledge of the participants was scored as a percentage and further classified as “good” or “poor”. Attitudes were classified as “positive”, “neutral”, or “negative” based on a calculated composite mean score. The participants were asked about standard food hygiene practices, and the practices were recorded based on how often they were performed, with the results recorded as “usually”, “sometimes”, or “never”. Results: The age range of the parents was between 18 and 65 years old, with a mean age of 28.9 ± 10.4 years. Among the participants, 96.2% were Saudi, and 81.8% were female. Almost 53% of the fathers and 41% of the mothers were university graduates. About 55% of the mothers were housewives. Almost equal proportions of the parents had “good” and “poor” levels of knowledge on food poisoning. Around 41% of the parents had positive attitudes towards safe food consumption. Older parents (defined as above 30 years of age), males, university graduates, and urban residents had significantly higher levels of knowledge regarding food poisoning. Conclusions: This study provided much needed information on the knowledge, attitudes, and practices related to food poisoning among parents in the Aseer region of Saudi Arabia. Although most respondents reported satisfactory practices, gaps were identified in knowledge and attitudes. This suggests a need for further investigation focused on the observed practices and strengthening health education activities for the community.

Food Safety Attitude and Associated Factors Among Mothers of Under 5 Children, Debarq Town: Community-Based Cross-Sectional Study, 2019

BACKGROUND

Food-borne diseases represent a widespread and growing public health problem, both in developed and developing countries. However, this problem has more impact on health and economy in developing countries than in developed countries but reliable data is not available.

METHODS

A cross-sectional study was done in 2019 at Debarq town, Amhara region, Northwest Ethiopia. A questionnaire prepared in English after adapted from previous studies then translated in to local language Amharic was used in order to collect the data. Data were checked manually for completeness, coded, and entered in to Epi Info version 7.1 and then exported in to SPSS version 26 statistical package for analyze. Descriptive statistics, percentage, frequency, standard deviation, and mean were analyzed. Likewise, bivariable and multivariable binary logistic regression analysis were done to know the relationship between the independent variables and attitude of food safety among mothers. The variables found having a P-value <.2 in the bivariable analysis were further analyzed in multivariable binary logistic regression. The variables with P-value <.05 were considered as significantly associated with food safety attitude of mothers.

RESULTS

About 423 mothers of under-5 children were involved in this study. The mean age of the participants was 39.844 ± 11.02. In this study, educational status (primary education (Adjusted Odds Ratio [AOR]: 2.66; 95% Confidence Interval [CI] [1.42-4.97]), secondary education (AOR: 2.66; 95% CI [3.35-14.05]), and diploma and above (AOR: 4.07; 95% CI [1.65-10.06])), higher income (AOR: 3.58; 95% CI [1.54-8.29]), good food safety knowledge (AOR: 3.08; 95% CI [1.51-6.242]) and good food hygiene practice (AOR: 3.97; 95% CI [2.33-6.75]) were factors associated with food safety attitude in the current study.

CONCLUSION

Significant proportion of participants in the study area had poor food safety attitude. Educational status, income, food safety knowledge, and food safety practice were significantly associated with food safety attitude among mothers. Food hygiene practice, knowledge, and level of education should be increased in order to improve food safety attitudes among mothers who were responsible in food processing at household level.

Food safety knowledge, attitude, and hygiene practices of street-cooked food handlers in North Dayi District, Ghana

BACKGROUND

Food safety and hygiene are currently a global health apprehension especially in unindustrialized countries as a result of increasing food-borne diseases (FBDs) and accompanying deaths. This study aimed at assessing knowledge, attitude, and hygiene practices (KAP) of food safety among street-cooked food handlers (SCFHs) in North Dayi District, Ghana.

METHODS

This was a descriptive cross-sectional study conducted on 407 SCFHs in North Dayi District, Ghana. The World Health Organization's Five Keys to Safer Food for food handlers and a pretested structured questionnaire were adapted for data collection among stationary SCFHs along principal streets. Significant parameters such as educational status, average monthly income, registered SCFHs, and food safety training course were used in bivariate and multivariate logistic regression models to calculate the power of the relationships observed.

RESULTS

The majority 84.3% of SCFHs were female and 56.0% had not attended a food safety training course. This study showed that 67.3%, 58.2%, and 62.9% of SCFHs had good levels of KAP of food safety, respectively. About 87.2% showed a good attitude of separating uncooked and prepared meal before storage. Good knowledge of food safety was 2 times higher among registered SCFHs compared to unregistered [cOR=1.64, p=0.032]. SCFHs with secondary education were 4 times good at hygiene practices of food safety likened to no education [aOR=4.06, p=0.003]. Above GHc1500 average monthly income earners were 5 times good at hygiene practices of food safety compared to below GHc500 [aOR=4.89, p=0.006]. Registered SCFHs were 8 times good at hygiene practice of food safety compared to unregistered [aOR=7.50, p<0.001]. The odd for good hygiene practice of food safety was 6 times found among SCFHs who had training on food safety courses likened to those who had not [aOR=5.97, p<0.001].

CONCLUSIONS

Over half of the SCFHs had good levels of KAP of food safety. Registering as SCFH was significantly associated with good knowledge and hygiene practices of food safety. Therefore, our results may present an imperative foundation for design to increase food safety and hygiene practice in the district, region, and beyond.

Knowledge, Attitude, Practice and Food Poisoning Associated Factors Among Parents in Bench-Sheko Zone, Southwest Ethiopia

BACKGROUND

Food poisoning is a food borne disease, mainly resulting from ingestion of food that contains a toxin, chemical or infectious microorganisms like bacteria, virus, parasite, or prion. On the other hand, avoiding food contamination during preparing and feeding is a key factor for reducing the prevalence of food poisoning. This study aimed to assess the knowledge, attitude, self-reported practice and food poisoning associated factors among parents in the selected health centers of Bench-Sheko Zone in Ethiopia.

METHODS

An institution-based cross-sectional study was conducted among 408 systematically selected parents in Bench-Sheko zone, Ethiopia. The data were collected through face to face interview using a structured questionnaire.

RESULTS

The median knowledge score was 8.0 with an interquartile range (IQR) of 8.0-10.0. The median attitude score was 9.0 with an IQR of 6.0-9.0. The median practice score was 12.0 with an IQR of 10.0-13.0. A positive correlation was seen between knowledge and attitudes of parents with food poisoning (r= 0.321, P < 0.026), between knowledge and practices of parents towards food poisoning (r= 0.312, P < 0.001) and between attitude and practices result towards food poisoning (r= 0.224, p < 0.031). The parents with a higher education level, employed and who live in a city were the factors significantly associated with higher knowledge scores (p < 0.05). The improved attitude was seen as educational level increased (p <0.05). The parents with female gender, employed and who live in a city were significantly associated with higher hygienic practices towards the prevention of food poisoning (p <0.05).

CONCLUSION

The knowledge, attitude, and self-reported practices of parents regarding food poisoning prevention are associated with each other and are affected by socio-demographic variables. Therefore, adequate emphasis should be given by health sectors to designing strong strategies which address the specific contributing factors for the problem.

Food Safety Knowledge, Handling Practices and Associated Factors Among Food Handlers Working in Food Establishments in Debre Markos Town, Northwest Ethiopia, 2020: Institution-Based Cross-Sectional Study

Purpose

Foodborne illness is a major public health problem worldwide. The supply of safe and healthy food is crucial to prevent foodborne illness. However, evidence regarding food safety knowledge and handling practice is limited in Ethiopia. Therefore, this study aimed to assess food safety knowledge, handling practice, and its associated factors among food handlers in Debre Markos Town, North West Ethiopia.

Patients and Methods

An institutional-based cross-sectional study was conducted on 408 randomly selected food handlers at Debre-Markos town. A structured questionnaire and an observational checklist were used to collect relevant data. The main outcome of interest was food safety and handling practice. Multivariable logistic regression analysis was used to identify the factors significantly associated with food safety knowledge and food handling practice. Data were analyzed using SPSS version 25.

Results

In this study, only 34.1% of food handlers had good food safety knowledge and nearly 54% of food handlers had good food handling practice. Level of education (AOR = 0.23 (0.14–0.57)), training on food safety (AOR = 5.13 (3.57–7.82)), and favorable attitudes towards food safety (AOR=2.54 (1.52–4.25)) were the factors associated with knowledge of food safety. Similarly, training (AOR=2.05, 95% CI=1.31–3.19), a good level of knowledge (AOR: 1.68, 95% CI: 1.40, 3.17), and work experience (AOR = 1.24, 95% CI: 1.10–2.81) were positively associated with good food handling practice.

Conclusion

In this study, the level of food safety knowledge and handling practices were relatively low. Therefore, the concerned bodies should work on the identified factors to improve food handlers’ knowledge of food safety and practice level. Continuous training for food handlers should be given.

Food Safety Practices among Postnatal Mothers in Western Ghana

Food safety has become a global issue due to the morbidity and mortality associated with it, particularly in developing countries. The objective of this community-based study is to examine food safety practices and its associated factors among postnatal mothers in the Western Region of Ghana. A cross-sectional survey study was conducted from August 1 2019 to January 31, 2020 from which data was obtained from the postnatal mothers (N = 300). The data was analysed using SPSS v.23. The findings suggest that majority (86%) of the respondents exhibited good food handling practices. Also, 66.3% and 91.7% of the respondents exhibited good food preparation and proper storage practices, respectively. Results also revealed that the odds of performing good handling practice among respondents within the age group of 36-45 years were five times higher compared to those within the age group of 18-25 years [OR = 4.92 (95% CI: 1.44–16.86), p = 0.011]. Moreover, respondents who had tertiary education qualifications were more likely to have proper food handling practices compared to those with primary education [OR = 0.27 (95% CI: 0.09–0.71), p = 0.009]. These findings provide useful insights for policy directions. The government of Ghana and other stakeholders should develop a communication strategy to increase and sustain publicity and education on food safety particularly to postnatal mothers and the citizenry in general.

Food Hygiene Practice and Its Determinants Among Food Handlers at University of Gondar, Northwest Ethiopia, 2019

Introduction

Food hygiene is an essential matter of public health for protecting or preventing diseases caused by unsafe food due to lack of good quality from production to consumption.

Objective

The current study aimed at assessing the food hygiene practice and determinant factors among food handlers working at the University of Gondar.

Methods

Univariate and multivariable binary logistic regression analyses were used to test the association of covariates with the food safety practice. Variables with p-value <0.2 were candidates for multivariable analysis. The adjusted odds ratio with 95% confidence interval and p-values less than 0.05 were used to report associations in the final model.

Results

A total of 184(46.7%) of the study subjects had good self-reported food hygiene practice. Being male [Adjusted odds ratio (AOR): 2.37, 95% confidence interval (CI) (1.34, 4.19)], educational status (primary [AOR: 2.54, 95% CI (1.16, 5.58)] and secondary [AOR: 2.20, 95% CI (1.11, 4.37)]), workers with greater than 2 years work experience [AOR: 1.86, 95% CI (1.06, 3.25)], monthly income of 2044–4867ETB/month [AOR: 2.05, 95% CI (1.01, 4.16)] were independent predictors of food safety practice of food handlers.

Conclusion and Recommendations

Below half of the study subjects had good self-reported food hygiene practice. Sex, educational status, and income were factors associated with the food hygiene practice. There should be continuous supportive supervision to raise the skills of food handlers to comply to better food hygiene practice. Food hygiene training should be given especially to female food handlers. Frequent audits are also required to ensure the permanence of effective and continuous training. Regular medical check up and strict hygiene follow-up should be encouraged to prevent foodborne disease outbreaks at universities.

Food Safety Practice and Associated Factors among Meat Handlers in Gondar Town: A Cross-Sectional Study

Introduction. Animal sources of foods (ASF), including meat, are a source of high-quality nutrients. However, meat composition makes it an ideal medium for the growth of a good number of microorganisms. Around 600 million foodborne illnesses and 420000 deaths occur each year due to poor food handling practice. Thus, probing into meat handling practice will be an insatiable input for the intervention. This study aims to investigate the level of meat handling practice and associated factors among meat handlers in butcheries in Gondar town, Ethiopia.

Method

The study was a community-based cross-sectional study among butcher shops in Gondar town from April 20 to 30, 2019. Data were collected using a pretested structured questionnaire by trained data collectors among 214 meat handlers from butcher shops. Multivariable logistic regression analysis with a 95% confidence interval (CI) was used to identify the factors significantly associated with a good level of meat handling practice.

Result

More than half of the meat handlers 66.4% (95% CI: (59.8, 72.4)) in butcher shops had a good level of meat handling practice. Level of attitude (AOR = 4.45; 95% CI, 2.09-9.43) and knowledge (AOR = 2.04; 95% CI, 1.09-3.82) were significantly associated with a good level of meat handling practice. The majority of respondents wash their hands after disposing garbage (91.6%) with less vigilance after smoking, sneezing, or coughing (64.0%).

Conclusion

The study revealed that the level of food handling practice was unsatisfactory among meat handlers. This result is a testimony to the prevailing potential risk faced by consumers due to the disregarding of hygienic behaviors by food handlers. Considering attitude and knowledge are associated with the outcome variable, investing time on behavioral change activities that will contribute to the improvement of meat handler's attitude & practice, primarily focusing on reducing working while ill is essential. Therefore, much supervisory and coaching work will be expected from local health departments & regulatory bodies.