Microbial Content of "Bowl Water" Used for Communal Handwashing in Preschools within Accra Metropolis, Ghana

A review on microorganisms and mycotoxin contamination of selected 'swallow meals' - Potential health risks to consumers

Swallow is a local parlance used by Nigerians to describe ready-to-eat pasty foods rich in carbohydrates which include fufu, pounded yam, amala, eba, lafun, tuwo, among others; molded in small size balls using the palm and dipped inside a bowl of nutritious and delicious soup (okro, edikaikong, egusi, bitter leaf soups etc.) before swallowing it. Swallow meals are often prepared in households and eateries, without strict implementation of food hygiene, which predisposes the meal to contamination by microorganisms. The use of palm, often not properly washed, to eat swallow meal is a common practice that is capable of contaminating the food. Since swallow meals are regarded as street foods, microbial contamination, and subsequent release of mycotoxins above permissible limits into the food is a threat to public health. Therefore, we reviewed scientific papers published from 2000 to 2023 that reported various microorganisms and mycotoxins associated with swallow meals, starting from the preparation stages to the plate-ready meal. The dominant bacteria reported were Bacillus spp. and Staphylococcus spp., while the fungi are Aspergillus spp. Mycotoxins, which include aflatoxin, fumonisins, among others, were detected in some swallow meals, soup ingredients, and raw foodstuffs. Although only two incidences of foodborne outbreaks linked to contaminated swallow meals were reported, there is a need to regularly monitor the microbiological quality of the meals to avoid future outbreaks.

Impact of In-Home Handwashing Stations on Hand Hygiene During the COVID-19 Pandemic in Unpiped Rural Alaska Native Homes

OBJECTIVES

More than 3300 rural Alaska Native homes lack piped water, impeding hand hygiene. During the COVID-19 pandemic, the Alaska Native Tribal Health Consortium and the Centers for Disease Control and Prevention partnered with 10 Tribal communities and regional Tribal health organizations to install a low-cost, intermediate-technology water and sanitation system, the Miniature Portable Alternative Sanitation System (Mini-PASS). We assessed the impact of the Mini-PASS handwashing station on handwashing, other water-related uses, and problems encountered over time.

METHODS

In this pre-postintervention study, we conducted semi-structured interviews by telephone seasonally with representatives of 71 households with the Mini-PASS from February 2021 through November 2022 to assess the impact of the units on water use and health.

RESULTS

Before Mini-PASS installation, all participating households primarily used washbasins for handwashing. Postintervention, more than 70% of households reported using the Mini-PASS as their primary handwashing method in all 3 follow-up intervals (3, 6-9, and 12 months postintervention). The proportion of households using the handwashing station for other household tasks increased during 12 months, from 51.4% (19 of 37) at 3 months postintervention to 77.8% (21 of 27) at 12 months postintervention. Although approximately 20% to 40% of households reported problems with their handwashing station during the 12 months postintervention, a large proportion of interviewees (47% to 60%) said they were able to conduct repairs themselves.

CONCLUSIONS

Households in rural Alaska quickly adopted the Mini-PASS for hand hygiene and other needs and were largely able to troubleshoot problems themselves. Further research evaluating the impact of improved handwashing behaviors facilitated by the Mini-PASS should be conducted.

Food and waterborne protozoan parasites: The African perspective

Parasitic food-borne diseases, particularly those caused by the protozoan parasites Cryptosporidium, Giardia, Cyclospora cayetanensis and Entamoeba are increasingly becoming common and have received considerable attention in the last two decades. The ability of the transmission stages of the parasites to survive in the environment for prolonged periods, globalization of the food industry and changes in eating habits have contributed to the numbers of human infections. This systematic scoping review highlights these important water- and foodborne parasites in the African context, detailing the burden in African water sources, wastewater/effluents and fresh produce. A scoping review search targeting African countries was conducted in Medline, Web of science and African journals online as well as back referencing from included studies covering the period 1990 to January 2020. Out of 1134 studies, 68 were included in the review. The articles covered 17 out of 54 African countries. There were 39/68 studies reporting on water sources while the rest reported on fresh produce. Cryptosporidium prevalence ranged from 6 to 100% in surface water, 4 to 100% in tap water and up to 100% in wastewater and sludge. In fresh produce, Cryptosporidium was reported from five countries with prevalence of 0.8-75%. Giardia was reported in 47 out of 68 articles; prevalence ranged from 2.4% in surface water; 1% to over 70% in tap water; 28-100% in wastewater and 2% - 99% in fresh produce. Prevalence of Cyclospora cayetanensis was lower. Prevalence of Entamoeba was 78% in surface water; 100% in wastewater and up to 99% in fresh produce. This study finds that Africa is no exception to the risk presented by the subject parasites from water and/or food sources. Routine screening for these parasites particularly at household level and provision of adequate and safe drinking water would help to control the parasites.

Food Hygiene Practices at the Ghana School Feeding Programme in Wa and Cape Coast Cities

Objective

The integrity and the wholesomeness of the food served to school pupils cannot be overlooked, especially when one considers the magnitude of health and sanitation issues that are plaguing the West African nations. This study aimed to investigate some of the personal hygiene practices by the pupils and the hygienic conditions in which food is cooked and served to these school-going children under the Ghana School Feeding Programme (GSFP).

Design

A cross-sectional and descriptive survey research designs were used in the study. Purposive and simple random sampling techniques were employed in selecting participants. Participants. There were 720 respondents for the study, comprising 600 pupils, 60 teachers, and 60 kitchen staff members from 20 schools. Information was obtained using questionnaire, observation, and unstructured interview instruments.

Results

Findings from the study revealed that the majority of pupils (92% in Wa and 65% in Cape Coast) did not wash their hands with soap under running water. No hand washing centers for pupils were also seen in most of the schools studied. Majority of the cooks did not have health certificate, and neither had attended any in-service training in two years. In both Wa and Cape Coast municipal schools, none of the kitchen staff admitted that pupils and teachers ever complained about the meals they served to the pupils.

Conclusion

The GSFP in basic schools forms part of the integral diet of the school children; hence, provision of good quality food can affect the health, learning, and physical activities of these children. Observational checklist revealed that most of the kitchen staff do not strictly adhere to basic food hygiene practices, and this affects the wholesomeness of the food served to the children. There is, therefore, a need for kitchen staff training on hygiene and food preparation practices.

Examining school-based hygiene facilities: a quantitative assessment in a Ghanaian municipality

Background

The crucial role of adequate water, sanitation and hygiene (WASH) facilities in influencing children’s handwashing behaviour is widely reported. Report from UNICEF indicates a dearth of adequate data on WASH facilities in schools, especially in the developing world. This study sought to contribute to building the evidence-base on school hygiene facilities in Ghana. The study further explored for possible associations and differences between key variables within the context of school water, sanitation and hygiene.

Methods

Data was collected from 37 junior high schools using an observational checklist. Methods of data analysis included a Scalogram model, Fisher’s exact test, and a Student’s t-test.

Results

Results of the study showed a facility deficiency in many schools: 33% of schools had students washing their hands in a shared receptacle (bowl), 24% had students using a single cotton towel to dry hands after handwashing, and only 16% of schools had a functional water facility. Furthermore, results of a proportion test indicated that 83% of schools which had functional water facilities also had functional handwashing stations. On the other hand, only 3% of schools which had functional water facilities also had a functional handwashing stations. A test of difference in the proportions of the two sets of schools showed a statistically significant difference (p < 0.001).

In addition, 40% of schools which had financial provisions for water supply also had functional handwashing stations. On the other hand, only 7% of schools which had financial provisions for water supply also had functional handwashing stations. There was a statistically significant difference in the proportions of the two sets of schools (p = 0.02).

Conclusion

We conclude that it is essential to have a financial provision for water supply in schools as this can potentially influence the existence of a handwashing station in a school. An intervention by government, educational authorities and civil society organisations towards enabling schools in low resource areas to have a sustainable budgetary allocation for WASH facilities would be timely.