Food Safety Knowledge, Attitudes, and Practices of Brazilian Food Truck Food Handlers

Food Safety Knowledge, Attitude, and Hygienic Practices of Food Handlers in Yeka Sub-city, Addis Ababa, Ethiopia: A Descriptive Cross-sectional Study

Introduction

Foodborne diseases pose a significant global public health threat, often originating from improper food handling practices. Given the crucial role of food handlers in preventing transmission of foodborne diseases, this study assessed the food safety knowledge, attitudes, and hygiene practices related to foodborne diseases among food handlers in food service establishments in Yeka Sub-city, Addis Ababa, Ethiopia.

Method

A descriptive cross-sectional study was conducted among 373 randomly selected food handlers. Data collection involved observing the kitchen hygiene practices and food handling practices through an observational checklist, and administering structured/standardized questionnaires. Statistical analysis was performed using SPSS version 20, with associations examined using the linear by linear association test. Spearman's correlation assessed relationships between knowledge, attitude, and practice cut points. Pre-testing and Cronbach's alpha were used to ensure the reproducibility, and reliability of the questionnaire.

Results

Majority of food handlers (50.1%) were aged less than 25 years, with 78.8% being female, and attended secondary school (46.4%). The overall knowledge (65%), positive attitude (92.2%), and hygiene practices (44%) of the food handlers toward food safety were good. Regarding the knowledge perspective, gaps existed in understanding disease transmission, notably Hepatitis A and tuberculosis. Although positive attitudes toward food safety were reported, observed practices were inconsistent, with a significant proportion admitting to working while ill. Compliance with uniform and protective gear was lacking. Marital status, Experience in food safety, and Work satisfaction has been shown to affect the knowledge, attitude, and hygiene practices of food handlers in this study.

Conclusion

This study highlights critical gaps in understanding disease transmission, and hygiene practices of food handlers in Yeka sub-city. Addressing these gaps will necessitate targeted interventions, including continuous education and training programs. Enhanced regulatory oversight is also needed to ensure compliance with food safety standards in public food establishments.

Antibiotic-Resistant Bacteria Isolated from Street Foods: A Systematic Review

Street food may be a vehicle of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) to humans. Foods contaminated with ARB entail serious problems or challenges in the fields of medical care, animal husbandry, food industry, and public health worldwide. The objectives of this systematic review were to identify and evaluate scientific reports associated with ARB isolated from various street foods. "Preferred reporting items for systematic reviews and meta-analysis" (PRISMA) guidelines were followed. The bibliographic material covers a period from January 2015 to April 2024. Six electronic scientific databases were searched individually for full-text articles; only those papers that met the inclusion and exclusion criteria were selected. Seventeen papers were included in this systematic review. This study highlighted the wide distribution of ARB resistant to β-lactams and other antibiotics, posing significant health risks to consumers. High resistance levels were observed for antibiotics such as ampicillin, ceftriaxone, and tetracycline, while some antibiotics, such as ceftazidime, clavulanic acid, cefoperazone, cotrimoxazole, doxycycline, doripenem, fosfomycin, vancomycin, and piperacillin-tazobactam, demonstrated 100% susceptibility. The prevalence of ARB in street foods varied between 5.2% and 70.8% among different countries. The multiple resistance of various bacteria, including Escherichia coli, Staphylococcus, Salmonella, and Klebsiella, to multiple classes of antibiotics, as well as environmental factors contributing to the spread of antibiotic resistance (AR), emphasize the urgent need for comprehensive approaches and coordinated efforts to confront antimicrobial resistance (AMR) under the "One Health" paradigm.

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.

Development of an Educational Gamification Strategy to Enhance the Food Safety Practices of Family Farmers in Public Food Markets of Northeast Brazil: A Case Study

This study aimed to develop an educational gamification strategy to enhance the food safety practices of family farmers in public food markets in a city in Northeastern Brazil (João Pessoa, PB, Brazil). A good manufacturing practices (GMP) checklist was used to verify hygienic-sanitary conditions in the food markets. Educational game tools addressing foodborne diseases and GMP with information about the prevention of foodborne diseases, good food handling practices, and safe food storage were developed. Pre- and post-training assessments were done to evaluate food handlers' knowledge and food safety practices. Microbiological parameters of food samples were analyzed before and two months after the training. Results indicated unsatisfactory hygiene conditions in the examined food markets. There was a very strong positive correlation between "implementation of GMP" and "production and process controls" (R = 0.95; p ≤ 0.05) and between "production and process controls" and "hygiene habits of handlers" (R = 0.92; p ≤0.05). There was no homogeneity between answers before and after the training for the knowledge of family farmers regarding "prevention of foodborne diseases" and "safe food handling". There were improvements in the measured microbiological parameters of foods sold by family farmers after the application of the developed educational gamification training. These results showed the developed educational game-based strategy as being effective in raising awareness of hygienic sanitary practices, helping to promote food safety, and reducing risks for the consumers of street foods at family farmers' markets.

Food handlers' knowledge, attitudes and self-reported practices regarding safe food handling in charitable food assistance programmes in the eThekwini District, South Africa: cross-sectional study

OBJECTIVE

This study aimed to assess food handlers' knowledge, attitudes and self-reported practices towards safer donated foods.

DESIGN

This cross-sectional study was conducted from January to May 2021.

SETTING

This study was conducted in the eThekwini District, South Africa.

PARTICIPANTS

A convenience sampling-based cross-sectional survey of food handlers (n=252) served as the study's main source of data. A total of eight study sites across five municipal planning regions of eThekwini District were visited. The principal investigator administered the validated structured standardised questionnaire, using participants' language of choice, which was either English or isiZulu. All the questions in the questionnaire were asked in exactly the same manner, following the same flow, in order to avoid bias and ensure consistency. Furthermore, the close-ended nature of questions in the questionnaire mitigated the risks of question manipulation. The questionnaire was adapted from the WHO's five keys to a safer food manual.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the knowledge, attitudes and self-reported practices towards safer donated foods. The secondary outcomes were the sanitary conditions of infrastructure and facilities, food handlers' observed food handling behaviour and nutritional information/labelling.

RESULTS

The results show that the food handlers had good knowledge, positive attitude and acceptable behaviours towards safe food handling and general hygiene, with mean scores (SD) of 62.8 (14.6), 92.5 (14.1) and 80.4 (13.3), respectively. Significant correlations were found between knowledge and attitudes (p=0001), knowledge and practices (p<0001), and attitudes and practices (p=0.02). However, the correlations between knowledge versus attitude and attitude versus practice were poor (Spearman's r<0.3), and the association between knowledge versus practice was moderate (0.3-0.7). The majority of food handlers (92.5%) did not understand the value of thorough cooking and temperature control. About 53% of respondents acknowledged to never adequately reheating cooked meals, 5% did not see the significance of preventing cross-contamination and 5% were unsure.

CONCLUSIONS

Despite the relatively positive knowledge, attitude and practice levels of the food handlers, safe food handling and hygiene practices, such as thorough cooking and temperature control, properly reheating cooked meals and taking precautions to prevent cross-contamination, require some emphasis.

Determinants of safe food handling practice among food handlers in food establishments, Yeka sub city, Addis Ababa, Ethiopia

Background

Poor food handling practice is a key cause of foodborne diseases notably in developing countries like Ethiopia. This study aimed to assess food safety knowledge, attitude and practice of food handlers, establishments' status and determinants of safe food handling practice.

Methods

The study utilized institution based cross-sectional study among food handlers working in Cafeterias, Restaurants and Hotels in Yeka sub city, Addis Ababa. A total of 284 food handlers: 69 from Cafeterias, 89 from Restaurants and 126 from non-stared Hotels were enrolled using stratified random sampling technique. Data were collected in observational checklist and through structured-questionnaire via face to face interview. A binary and multivariate logistic regression was used and adjusted for cofounders. A P-value of less than 0.05 was considered statistically significant.

Result

The present study has indicated 42.6% of food handlers had good food handling practice. Food handling practice in the establishments were significantly associated with sex, monthly income, availability of functional pipe water supply, availability of soap and/or detergents and presence of insects or rodents.

Conclusion

Food handlers in the study area were executing in a poor food handling practice, as most of them were not knowledgeable as needed. In fact, revising the salary of food handlers based on their work load could be valid, as there is existing worldwide economic inflation. Likewise enhancing pipe water availability in the food premises and dispatching sufficient soaps and detergents coupled with eradicating ubiquitous insects and rodents are key.

A systematic review of the knowledge, attitude, and practices (KAP) of food safety among street food handlers

Foodborne diseases are commonly reported from various food establishments; however, little information has been obtained on this topic from the street food industry. Therefore, the present systematic review aimed to provide an overview of the knowledge, attitude, and practices (KAP) of food safety among street food handlers to highlight relevant gaps in the safety and quality of food handling. Articles included in the present systematic review were extracted from several electronic databases based on the PRISMA protocol and CASP checklist. By applying inclusion criteria, twelve peer-reviewed studies from 2010 to 2020 were included in the present systematic review. Results revealed that the food safety KAP level among street food handlers varied across the study settings. It was also found that training plays an essential role in improving food safety practices. KAP assessment is essential as an initial diagnosis to guide and prioritise appropriate strategies based on the food safety aspect that requires the most attention. It also provides a decision-making basis for food safety authorities to develop relevant policies, and organise food safety training.

Job Crafting and Burnout as Predictors of Food Safety Behaviors in the Foodservice Industry

This study aimed to investigate whether job crafting, burnout, and work engagement predict food safety behaviors in the foodservice industry. It was a cross-sectional study conducted in Cuiabá (Brazil) among foodservice workers. Four instruments were used among foodservice workers for the examination: (a) job demands and resources, (b) job satisfaction, (c) burnout, and (d) work engagement. Food safety practices were measured using a validated risk-based checklist. Partial least squares structural equation modeling was used to test the hypothesis model. In this study, 22 restaurants and 302 foodservice workers were examined. It was found that the “job demands-resources” model was valid for foodservice workers, i.e., burnout was strongly predicted by job demands (β = 0.550; p < 0.001); job resources were a positive predictor of work engagement (β = 0.258; p < 0.001); and burnout was a negative predictor of work engagement (β = −0.411; p < 0.001). Food safety violations were predicted by job crafting (β = −0.125; p = 0.029) and burnout (β = 0.143; p = 0.016). The results indicate that mitigating burnout and increasing job crafting can be important supporting strategies to improve food safety behaviors.

Assessment of food safety knowledge, attitude, practices of food handlers and microbial contamination in foods at the canteens of a University in Pakistan

Developing nations are striving to assure food safety that rely mainly upon handling procedures. The current study focused upon the understanding level and practices of food handlers working at various canteens of University of the Punjab, Quid-i-Azam campus, Lahore. Different canteens were selected where 300 different food handlers were judged for their approach towards food safety through a closed ended questionnaire. Samples of different food products were also taken randomly for their microbiological safety evaluation. The whole data was analyzed using chi-square to assess the proportion of correct and incorrect responses among various parameters. The non-significant variation was observed among the knowledge, attitude and practices scores of university and its hostels’ canteens food handlers. Overall, 60% of the responses were correct from the university and hostel canteens food handlers. Similarly, 50-60% of the responses regarding attitude and practices were correct from the university and hostel canteen food handlers. With many technical flaws, these food handlers showed moderate level of knowledge. Not only apprentices but the supervisors too, lacked the basic knowledge of temperature as major factor creating potential food safety threats. Lack of knowledge about personal hygiene and workplace sanitation were few contributing factors towards heedless behavior. Incidence of Salmonella and Staphylococcus aureus contamination in food samples was found 29% and 57%, respectively, while 35% food samples were found contaminated with E. coli. It further exposed the negligence, emphasizing proper training of employees as part and parcel of food safety procedures. It was concluded that more training programs along with periodic validation of food manufacturing standards are required to ensure food safety. Furthermore, strict surveillance and implementation of GMPs by the administrative authorities are needed to safeguard the consumers’ health.

The Food Safety Knowledge, Attitude and Practice of Malaysian Food Truck Vendors during the COVID-19 Pandemic

Foodborne diseases are one of the greatest public health threats, but they can be prevented by maintaining food safety practices. Although the food safety literature has been awash with studies from various food operations, there is very limited information on food safety in the food truck business. Therefore, this study aims to assess the level of knowledge, attitude, and practices related to food safety among food truck vendors. A cross-sectional study was conducted among 396 Malaysian food truck vendors using convenience sampling. Data was collected during the Recovery Movement Control Order due to the COVID-19 pandemic through a validated self-administered questionnaire and analyzed using SPSS version 25. The findings indicated that food truck vendors generally have fair knowledge (M = 78.8, SD = 9.09), a positive attitude (M = 94.8, SD = 5.95), and good practices (M = 84.7, SD = 6.62) regarding food safety during the COVID-19 pandemic. Hierarchical regression analysis further showed that food truck vendors’ level of education and knowledge of food safety are significant predictors of their food safety practices. This study provides an initial understanding of the food safety knowledge, attitude, and practices among food truck vendors and yields important information in promoting the food safety culture.

A cross-sectional study design to determine the prevalence of knowledge, attitude, and the preventive practice of food poisoning and its factors among postgraduate students in a public university in Selangor, Malaysia

Objectives

This study is designed to determine the knowledge, attitude, and practice of food poisoning and its factors among postgraduate students in Universiti Putra Malaysia.

Methods

A cross-sectional study was conducted among 212 respondents who were selected through simple random sampling. Data was generated using a validated and reliable self-administered questionnaire.

Results

The majority of the respondents are male, aged less than 35 years old, non-Malaysian, single, first-degree holders, not working, received a monthly income of less than 3264 Malaysian Ringgit, aware of food poisoning outbreak and the sources of their information of the food poisoning outbreak were television, the internet, newspaper, Online journals, friends, Facebook, community, nurse, drinking raw milk for the second time, information from their parents, relatives, restaurant, and radio. Majority had previous history of food poisoning illness but didn’t correctly confirm the causes of their food poisoning illness. Majority had poor knowledge, acceptable attitude, and good practice of food poisoning. A significant association was observed for citizen, marital status, awareness of food poisoning outbreak, and previous history of food poisoning illness with knowledge. Gender and awareness of food poisoning outbreak were significantly associated with attitude. Attitude and practice were significantly associated. Logistic regression revealed that being married, awareness of food poisoning outbreak, and previous history of food poisoning illness are predictors for good knowledge. Female respondents and awareness of food poisoning outbreak are predictors for acceptable attitude.

Conclusion

Documentation of the identified poor knowledge and factors affecting knowledge, attitude, and practice provides essential information on the baseline indicators towards the risk of food poisoning among the respondents. A relevant interventional program is highly recommended to prevent the potential risks of food poisoning outbreak among them.

Food hygiene practice and its associated factors among food handlers working in food establishments during the COVID-19 pandemic in East Gojjam and West Gojjam Zones, North West Ethiopia

Objectives:

This study was aimed to assess the food hygiene practice and associated factors among food handlers working in food establishments during the COVID-19 pandemic in East Gojjam and West Gojjam Zones, North West Ethiopia.

Methods:

A facility-based cross-sectional study was conducted among 845 food handlers working in 423 selected food establishments of East and West Gojjam Zones from 22 September to 2 November 2020. The food handlers were categorized as a cooker and a waiter based on their responsibility. A data collection tool was adapted from the literature and validated by conducting a pre-test prior to the study. Binary logistic regression was done to identify the factors associated with food hygiene practice among food handlers.

Results:

The prevalence of poor food hygiene practices among food handlers working in food establishments was 51.2% (95% confidence interval = 47.8, 54.6%). Being both a cooker and waiter (adjusted odds ratio = 2.98; 95% confidence interval = 1.02, 8.66), availability of personal protective equipment (adjusted odds ratio = 2.67; 95% confidence interval = 1.75, 4.08), presence of pipe water in the kitchen (adjusted odds ratio = 2.73; 95% confidence interval = 1.84, 4.06), presence of a supervisor (adjusted odds ratio = 2.26; 95% confidence interval = 1.41, 3.62), and separate dressing room (adjusted odds ratio = 2.69; 95% confidence interval = 1.84, 3.93) were significantly associated with food hygiene practice among food handlers.

Conclusion:

The prevalence of poor food hygiene practices among food handlers working in food establishments during the COVID-19 pandemic was high. Therefore, improving food hygiene practice focusing on availing personal protective equipment, pipe water in the kitchen, and ensuring the presence of a supervisor as well as a separate dressing room in the food establishment is recommended.

An Evaluation of the Hygiene Practices of Polish Street Food Vendors in Selected Food Trucks and Stands

Today, street food vending is becoming a dynamically developing food industry in Europe, including Poland. Lifestyle changes and socioeconomic factors, especially among young consumers, make it a convenient food alternative, even in countries without this tradition. The aim of the study was to evaluate hygiene conditions and practices in selected street food facilities in Poland. The study was carried out in accordance with an observation checklist developed on the basis of the hygienic requirements of the European Union. The study covered 550 randomly selected street food vendors in Poland in 10 cities. The hygiene of street food outlets was assessed in three aspects: ensuring proper production conditions, hygiene of production and distribution, and hygiene of personnel. The evaluation of street food outlets showed that the level of hygiene was not fully acceptable. A small percentage of the examined objects satisfactorily fulfilled the requirements of the production conditions, production and distribution hygiene, and staff hygiene. The proposed hygienic checklist for quick daily monitoring of street food outlets can be used to perform internal and external inspections. It seems that specific codes of conduct for European street foods facilities are necessary.

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.

Consumer Eating Behavior and Opinions about the Food Safety of Street Food in Poland

Street food plays an increasingly important role in the nutrition of the inhabitants of European cities. Our study aimed to analyze Polish consumers’ attitudes toward food offered in street food outlets, consumers’ eating out behavior, and the factors that determine their choice of meals from street food vendors. A survey was conducted of 1300 adult respondents who eat street food in Poland. The research enabled a detailed and comprehensive assessment of consumer behavior toward the use of street food outlets, as well as consumer opinions on vendors’ functioning, including hygiene and meals offered. Factors determining the frequency of street food consumption, preferred food types, and factors influencing the use of such outlets were identified. The most important factors were the quality of services and meals, personal preferences and price. Using cluster analysis, consumer profiles based on the types of street food outlets and food preferred were identified. Four main street food consumer preference profiles were identified: ‘burger-enthusiasts’, ‘kebab-enthusiasts’ and ‘ice-cream enthusiasts’, and ‘no specific-oriented consumers’. The Internet and social media were identified as information and promotion channels for this form of gastronomy. Results also revealed Polish consumer behavior and opinions about the food safety of street food in Poland. In summary, in Poland the habits of eating typical Polish homemade dishes is being replaced by eating meals in street food outlets, which can be classified as fast food. Increasing consumer knowledge and awareness of the quality and safety of street food may counteract improper hygiene practices of sellers.

Food Safety Knowledge, Attitudes, and Self-Reported Practices Among Medical Staff in China Before, During and After the COVID-19 Pandemic

PURPOSE

To compare food safety knowledge, attitudes, and self-reported practices among medical staff in China before, during, and after the COVID-19 pandemic.

PATIENTS AND METHODS

The questionnaire was anonymous. All respondents were Chinese medical personnel. A Chi-square contingency table was used to compare the knowledge and attitudes of Chinese medical staff before, during and after COVID-19. R statistical software (v4.0.0) was used for analysis.

RESULTS

A total of 1431 valid responses (57.3% from female respondents) were included in our analysis. Medical professionals were geographically distributed as follows: eastern China, 55.5%; central China, 19.7%; western China, 24.1%; Hong Kong, Macau, or Taiwan, 0.05%. Medical professionals reported that they paid greater attention to food safety after the COVID-19 pandemic compared with before the epidemic. Self-reported knowledge of and attitudes toward food safety among medical staff were significantly different before, during, and after the COVID-19 pandemic (both P<0.001).

CONCLUSION

After the COVID-19 pandemic, medical professionals paid increasing attention to food safety, which is a clinically important change. Because medical professionals can influence public understanding of food safety, their increased attention to this subject may enable them to promote food safety knowledge more actively in their work. This may in turn promote a better understanding of food safety and protect the health of the general public.

A Systematic Review and Meta-Analysis of the Effects of Food Safety and Hygiene Training on Food Handlers

Foodborne diseases are a significant cause of morbidity and mortality worldwide. Studies have shown that the knowledge, attitude, and practices of food handlers are important factors in preventing foodborne illness. The purpose of this research is to assess the effects of training interventions on knowledge, attitude, and practice on food safety and hygiene among food handlers at different stages of the food supply chain. To this end, we conducted a systematic review and meta-analysis with close adherence to the PRISMA guidelines. We searched for training interventions among food handlers in five databases. Randomized control trials (RCT), quasi-RCTs, controlled before-after, and nonrandomized designs, including pre-post studies, were analyzed to allow a more comprehensive assessment. The meta-analysis was conducted using the random-effects model to calculate the effect sizes (Hedges's g) and 95% confidence interval (CI). Out of 1094 studies, 31 were included. Results showed an effect size of 1.24 (CI = 0.89-1.58) for knowledge, an attitude effect size of 0.28 (CI = 0.07-0.48), and an overall practice effect size of 0.65 (CI = 0.24-1.06). In addition, subgroups of self-reported practices and observed practices presented effect sizes of 0.80 (CI = 0.13-1.48) and 0.45 (CI = 0.15-0.76) respectively.

Microbiological Safety of Street-Vended Beverages in Chow Kit, Kuala Lumpur

Improper handling, poor hygienic practices, and lack of environmental control affect the safety of street-vended beverages. The objective of this study is to determine the bacterial contamination level of three types of beverages (cordial-based drinks, milk-based drinks, fruit juices) sold by street vendors at Chow Kit, Kuala Lumpur. A total of 31 samples of beverages were analyzed to determine total viable count (TVC), total coliform, Escherichia coli, and Staphylococcus aureus counts via the standard plate count method. The results showed that only 9.7% of the total samples were not contaminated with the tested microorganisms. All milk-based drink samples were positive for TVC and also had the highest average bacterial counts at 5.30 ± 1.11 log Colony Forming Unit/mL (CFU/mL). About 71% of the samples were contaminated with total coliform with the average readings ranging between 4.30 and 4.75 log CFU/mL, whereas 58.1% of the samples were positive with S. aureus, with fruit juices having the highest average reading (3.42 ± 1.15 log CFU/mL). Only one sample (milk-based drink) was E. coli positive. This study showed that the microbiological safety level of street-vended beverages in Chow Kit, Kuala Lumpur was average and needs to be improved. Provision of food safety education and adequate sanitary facilities at vending sites are suggested to increase the safety of food products.